Technical difficulties and countermeasures of caudate lobectomy

Caudate lobectomy is still a great challenge for surgeons due to unique anatomy of caudate lobe. A 38-year-old male patient with a huge recurrent hepatic cancer (diameter=16 cm) in caudate lobe received caudate lobectomy with portal triad and inferior vena cava clamping. The operation was paused due to hemorrhage (volume of blood loss=1000 ml). After heat preservation and blood transfusion, the caudate lobectomy was completely removed with inferior vena cava clamping. The patient gradually recovered, and no tumor recurrence was detected during the follow up (14 months). Caudate lobectomy could be safely carried out under the condition of accurate preoperational estimation, clear indication for surgery and precise hepatectomy.