ABSTRACT
The caudate lobe, deeply situated and surrounded by major vascular structures, is an area of the liver often seen as forbidding and dangerous. The pioneering work of Couinaud 1 provided a much clearer understanding of hepatic anatomy and allowed a safer, anatomically-based approach to hepatic resectional surgery. As hepatic surgery has advanced, surgeons have increasingly and successfully pursued resection of caudate lobe lesions. The caudate lobe is not infrequently involved in primary and secondary malignancies. While rarely
Figure 3.1 Schematic view of the caudate lobe (segment I, shaded), looking from above with the left lateral segment (segments II/III) retracted to the patient’s right. The caudate is bounded anteriorly by the left portal vein (LPV) and posteriorly by the inferior vena cava (IVC). The principal portal venous supply, arising from the LPV, is indicated by the arrow. The ligamentum venosum runs along the anterior border of the caudate, from the LPV to the base of the left hepatic vein (LHV). PV, main portal vein; RPV, right portal vein; MHV, middle hepatic vein.
