Anatomical liver resection of segment 4a en bloc with the caudate lobe

Anatomical segmentectomy is the complete resection of an area supplied by a segmental portal branch. Among segmentectomies, isolated\r\nsegmentectomy 4 is a technically demanding procedure because there are two transection planes: on the left side along the umbilical fissure and, on\r\nthe right side, along the middle hepatic vein. Although there are several reports on anatomic segmentectomies, only few regard the anatomic\r\nsegmentectomy 4a. We report here the case of a 60-year-old man who underwent anatomical segmentectomy 4a en bloc with the caudate lobe to\r\nresect a colorectal liver metastasis located in segment 4a and involving the paracaval portion of the caudate lobe. This type of procedure was planned\r\nin order to maximize the postoperative functional hepatic reserve, thereby reducing the risk of postoperative liver failure and ultimately allowing the\r\npossibility for future repeat hepatectomy in case of recurrence.