Applied anatomy and surgical resection of the hepatic caudate lobe / 中华肝胆外科杂志

ABSTRACT

Objective To study the anatomy of the caudate lobe and to apply the knowledge in caudate lobe resection and piggyback liver transplantation. Methods Dissection of the caudate lobe was carried out in 35 fresh adult livers. Before dissection, the portal venous system was injected with barium sulfate emulsion to show the portal branches of the caudate lobe. Results The caudate lobe was shown to consiste of 3 portions (1) the Spigelian lobe, the paracaval portion and the caudate process. The Spigelian lobe was pyramidal in shape with 3 faces, a peak and a base; (2) the paracaval portion was situated to the right and to the front of the vena cava; (3) the caudal process was the liver parenchyma between the hepatic hilum and the anterior aspect of the vena cava. Conclusions The entire caudate lobe is situated at the posterior part of the liver and it surrounds the vena cava. The key point in resecting the entire caudate lobe or in performing a piggyback liver transplantation is adequate mobilization and division of all the outflowing veins of the caudate lobe.