Quadrate lobe

The rate of resectability is only 15-20% for proximal bile duct carcinomas but up to 70% for distal lesions. In addition, there is little benefit to preoperative decompression of the biliary tree in patients having obstructive jaundice (65,66). However, this procedure is frequently practiced. For proximal cancers, local excision is often possible. In particular, hepatic resection is indicated for upper bile duct cancers with quadrate lobe invasion or unilateral intrahepatic ductal or vascular involvement, and distal and midductal lesions may require pancreatoduodenectomy. Also, biliary-enteric continuity... 

Gallbladder (cholecyst vesica bUiaris vesica fellea). The pear-shaped reservoir for the bile in the post inferior surface of he liver, between the right and quadrate lobe the cystic duct projects to join the common bile duct. 

Fig. 2.5 Segmentation of the liver. a ie/t/oZie (1,1-4) 4 segments centre of the liver (II) quadrate lobe (II, 3) caudate lobe (II, 1,2) and caudate process (II, 2) right lobe (HI, 1 -4) 4 segments. Rex-Cantlie s line (= = = ) as functional division between both liver lobes runs between II 2,4 and II 1,3. Topographically, the liver lobes are...

Lafortune, M., Matricardi, L., Denys, A., Favret, M., Dery, R., Ponnier-Layrargues, G. Segment 4 (the quadrate lobe) a barometer of cirrhotic liver disease at US. Radiology 1998 206 157-160... 

The left pedicle runs almost horizontal and separates a quadrate lobe anteriorly and a caudate lobe... 

Fig. 4.2. Inferior aspect of the liver the round ligament continues into the umhilical portion of the left portal vein (at an anatomical landmark called Rex s recessus). The hepatic pedicle spreads out, near the liver, as a virtual space called the porta hepatis or hepatic hilum (defined by the bifurcation of the portal vein) and divides into a shorter right pedicle and a longer left pedicle. The left pedicle separates a quadrate lobe anteriorly and a round caudate lobe posteriorly and arches up as an umbilical portion to join the round ligament. Arantius ligament runs from the angle between the transverse portion and the umbilical portion of the left portal vein to the confluence of the left and middle hepatic veins. The right hepatic pedicle is in contact with the gallbladder that defines the right border of the quadrate lobe. Posteriorly the right hepatic pedicle is separated from the vena cava by a rim of liver tissue that corresponds to the right portion of the caudate lobe...

The right hepatic pedicle is in contact with the gallbladder that defines the right border of the quadrate lobe. Posteriorly the right hepatic pedicle is separated from the vena cava by a rim of liver tissue that corresponds to the right portion of the caudate lobe. 

Linkola (1918), one of the earliest workers, employed the simplest technique. He set up a base point, either a nail driven into wood near the thallus or a chisel mark for rock quadrats, and measured from the base point to the lobe tip, expressing his data as radial increase of individual lobes in millimeters per year. This exact technique was followed by Hakulinen (1966). A modification has been proposed by Hale (1970) where a point or mark on the lobe surface becomes a base point, thus reducing the slight error caused by expansion of the mature central parts of the thallus. 

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