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01-10-2018 | Original Article

Anatomical Boundary Between the Caudate Lobe of the Liver and Adjacent Segments Based on Three-Dimensional Analysis for Precise Resections

Authors: Harufumi Maki, Yoshihiro Sakamoto, Yoshikuni Kawaguchi, Nobuhisa Akamatsu, Junichi Kaneko, Junichi Arita, Kiyoshi Hasegawa, Norihiro Kokudo

Published in: Journal of Gastrointestinal Surgery | Issue 10/2018

Abstract

Background

Right hemihepatectomy or systematic resection of segment 7 or 8 involves partial resection of the paracaval portion of the caudate lobe. However, the boundary between the caudate lobe and segment 7 or 8 remains unclear. We examined the anatomical territory of the caudate lobe with special reference to the boundary between the paracaval portion and segment 7 or 8 for precise anatomical hepatectomies.

Methods

We enrolled 63 consecutive healthy donor candidates for living-donor liver transplantation from 2012 to 2014 in this study. The caudate lobe was defined according to Kumon’s subdivision system, and the boundary between the paracaval portion and segment 7 or 8 was investigated based on three-dimensional computed tomography scan images using SYNAPSE VINCENT^®.

Results

The paracaval portion of the liver protruded on the liver surface underneath the right diaphragm on the ventral side of the right hepatic vein (RHV) in 10 participants (16%) and on the dorsal side of the RHV in 9 participants (14%). A branch of the RHV, the “paracaval vein,” was found in all 63 participants and ran longitudinally along the right border of the paracaval portion (n = 30, 48%) and within segment 7 (n = 16, 25%) or segment 8 (n = 17, 27%).

Conclusions

The paracaval portion of the liver protruded on the liver surface underneath the right diaphragm in one third of our participants. The paracaval vein can be a landmark for the boundary between the caudate lobe and the segment 7 or 8 in half of the cases.

Makuuchi M, Hasegawa H, Yamazaki S. Ultrasonically guided subsegmentectomy. Surg Gynecol Obstet 1985; 161: 346–350.PubMed

Takayama T, Makuuchi M, Watanabe K, Kosuge T, Takayasu K, Yamazaki S, Hasegawa H. A new method for mapping hepatic subsegment: counterstaining identification technique. Surgery 1991;109(2):226–9.PubMed

Couinaud CM. A simplified method for controlled left hepatectomy. Surgery 1985; 97: 358–361.PubMed

Takasaki K, Kobayashi S, Tanaka S, Saito A, Yamamoto M, Hanyu F. Highly anatomically systematized hepatic resection with Glissonean sheath code transection at the hepatic hilus. Int Surg 1990; 75: 73–77.PubMed

Aoki T, Yasuda D, Shimizu Y, Odaira M, Niiya T, Kusano T, Mitamura K, Hayashi K, Murai N, Koizumi T, Kato H, Enami Y, Miwa M, Kusano M. Image-guided liver mapping using fluorescence navigation system with indocyanine green for anatomical hepatic resection. World J Surg 2008;32(8):1763–7.CrossRefPubMed

Miyata A, Ishizawa T, Tani K, Shimizu A, Kaneko J, Aoki T, Sakamoto Y, Sugawara Y, Hasegawa K, Kokudo N. Reappraisal of a dye-staining technique for anatomic hepatectomy by the concomitant use of indocyanine green fluorescence imaging. J Am Coll Surg. 2015;221(2):e27–36.CrossRefPubMed

Takayama T, Tanaka T, Higaki T, Katou K, Teshima Y, Makuuchi M. High dorsal resection of the liver. J Am Coll Surg 1994; 179: 72–75.PubMed

Kosuge T, Yamamoto J, Takayama T, Shimada K, Yamasaki S, Makuuchi M, Hasegawa H. An isolated, complete resection of the caudate lobe, including the paracaval portion, for hepatocellular carcinoma. Arch Surg 1994;129(3):280–4.CrossRefPubMed

Yanaga K, Matsumata T, Hayashi H, Shimada M, Urata K, Sugimachi K. Isolated hepatic caudate lobectomy. Surgery 1994; 115: 757–761.PubMed

10.

Bartlett D, Fong Y, Blumgart LH. Complete resection of the caudate lobe of the liver: technique and results. Br J Surg 1996; 83: 1076–1081.CrossRefPubMed

11.

Nimura Y, Hayakawa N, Kamiya J, Kondo S, Shionoya S. Hepatic segmentectomy with caudate lobe resection for bile duct carcinoma of the hepatic hilus. World J Surg 1990; 14: 535–543; discussion 44.CrossRefPubMed

12.

Natsume S, Ebata T, Yokoyama Y, Igami T, Sugawara G, Shimoyama Y, Nagino M. Clinical significance of left trisectionectomy for perihilar cholangiocarcinoma: an appraisal and comparison with left hepatectomy. Ann Surg. 2012;255(4):754–62.CrossRefPubMed

13.

Kumon M. Anatomy of the caudate lobe with special reference to portal vein and bile duct. Acta Hepatol Jpn 1985; 26: 1193–1199.CrossRef

14.

Kumon M. Anatomical study of the caudate lobe with special reference to portal venous and biliary branches using corrosion liver casts and clinical application. Liver Cancer 2017; 6: 161–170.CrossRefPubMed

15.

Kogure K, Kuwano H, Yorifuji H, Ishikawa H, Takata K, Makuuchi M. The caudate processus hepatic vein: a boundary hepatic vein between the caudate lobe and the right liver. Ann Surg 2008; 247: 288–293.CrossRefPubMed

16.

Satou S, Sugawara Y, Tamura S, Kishi Y, Kaneko J, Matsui Y, Kokudo N, Makuuchi M. Three-dimensional computed tomography for planning donor hepatectomy. Transplant Proc 2007;39(1):145–9.CrossRefPubMed

17.

Kogure K, Kuwano H, Fujimaki N, Makuuchi M. Relation among portal segmentation, proper hepatic vein, and external notch of the caudate lobe in the human liver. Ann Surg 2000; 231: 223–228.CrossRefPubMedPubMedCentral

18.

Kitagawa S, Murakami G, Hata F, Hirata K. Configuration of the right portion of the caudate lobe with special reference to identification of its right margin. Clin Anat 2000;13:321–40.CrossRefPubMed

19.

Kwon D, Murakami G, Hata F, Wang HJ, Chung MS, Hirata K. Location of the ventral margin of the paracaval portion of the caudate lobe of the human liver with special reference to the configuration of hepatic portal vein branches. Clin Anat 2002;15:387–401.CrossRefPubMed

20.

Kishi Y, Hasegawa K, Kaneko J, Aoki T, Beck Y, Sugawara Y, Makuuchi M, Kokudo N. Resection of segment VIII for hepatocellular carcinoma. Br J Surg 2012;99(8):1105–12.CrossRefPubMed

Title: Anatomical Boundary Between the Caudate Lobe of the Liver and Adjacent Segments Based on Three-Dimensional Analysis for Precise Resections
Authors: Harufumi Maki
Yoshihiro Sakamoto
Yoshikuni Kawaguchi
Nobuhisa Akamatsu
Junichi Kaneko
Junichi Arita
Kiyoshi Hasegawa
Norihiro Kokudo
Publication date: 01-10-2018
Publisher: Springer US
Published in: Journal of Gastrointestinal Surgery / Issue 10/2018
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-018-3819-5

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Anatomical Boundary Between the Caudate Lobe of the Liver and Adjacent Segments Based on Three-Dimensional Analysis for Precise Resections

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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