Human liver caudate lobe and liver segment

Abstract

Recently, the caudate lobe has seemed to be the final target for aggressive cancer surgery of the liver. This lobe has five surfaces: the dorsal, left and hilar-free surfaces and the right and ventral-border planes. Surgeons have divided the caudate lobe into three parts: Spiegel's lobe, which is called the 'caudate lobe and papillary process' by anatomists, the caudate process, viewed as almost the same entity by anatomists, and the paracaval portion corresponding to the dorsally located parenchyma in front of the inferior vena cava. All three parts are supplied by primary branches originating from the left and right portal veins, including the hilar bifurcation area. The hilar bifurcation branch often (50%) supplies the paracaval portion and it sometimes (29%) extends its territory to Spiegel's lobe. It was postulated by Couinaud that the paracaval portion or the S9 is not defined by its supplying portal vein branch but by its 'dorsal location' in the liver. Couinaud's caudate lobe or dorsal-liver concept cause, and still now causes, great logical confusion for surgeons. We attempt here to describe the margins of the lobe, border branches of the portal vein, the left/right territorial border of the portal vein or Cantile's line and other topics closely relating to the surgery within these contexts. Finally, the caudate lobe as a liver segment will be discussed.

2005 PRETEXT: a revised staging system for primary malignant liver tumours of childhood developed by the SIOPEL group

“…The main problem, however, is the imperfect correlation with segments defined by the branching pattern of the portal veins [8, 11–13]. Although the plane of the right hepatic vein reliably separates the right posterior and anterior sections [9], the left hepatic vein runs to the left of the boundary between the left lateral and medial sections, which is best defined by the plane of the fissure of the ligamentum teres and the umbilical portion of the left portal vein (Fig. 1) [14].…”

Caudate lobe-sparing subtotal hepatectomy for primary hepatolithiasis

“…It consists of the Spigelian lobe, the paracaval portion and the caudate process. Each of these three parts of the caudate lobe has its own biliary and blood supply9–11. It is, therefore, not surprising that primary hepatolithiasis can affect the main liver (Couinaud segments II–VIII) without affecting the caudate lobe.…”

Arterial supply and biliary drainage of the dorsal liver: A dissection study using controlled specimens

“…3). Dissections were conducted from the visceral surface to the diaphragmatic surface according to our previous studies (reviewed by Murakami & Hata, 2002).…”

“…Murakami and Hata (2002) hypothesized that, according to ramification patterns of the bile drainage and/or arterial supply, the HB territory (i.e. an intermediate area between the left and right portal vein territories) was likely to be divided into the left or right anatomical lobes of the liver.…”

“…The caudate lobe is defined anatomically by an area supplied by the primary rami originating from the left and right portal veins and their hilar bifurcation (HB). The HB or an intermediate area between the left and right portal veins issues the caudate lobe branch in almost half of specimens (Murakami & Hata, 2002). According to Couinaud's liver segment system (segments I–VIII or S1–S8; reviewed by Williams, 1995), the paracavally located liver parenchyme ‘was’ composed of both the paracaval portion of the caudate lobe (parts of S1) and parts of S7 and/or S8.…”