Associating liver partition and portal vein ligation for staged hepatectomy: the current role and development

Lau, Wan Yee; Lai, Eric Ch; Lau, Stephanie Hy

doi:10.1016/s1499-3872(16)60174-1

Cited by 24 publications

(26 citation statements)

References 71 publications

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“…Si bien, esta técnica ha demostrado tener una hipertrofia adecuada del RHF en un periodo de tiempo más corto y más constante que la EP o LP, también es cierto que la morbilidad y mortalidad asociada a la técnica fueron excesivamente elevadas al comienzo de la técnica lo que generó algunos reparos sobre su verdadera utilidad 18,19 .…”

Section: Discussionunclassified

Hepatectomía en 2 tiempos con técnica de ALPPS (Asociación de bipartición hepática con ligadura portal para hepatectomía en 2 tiempos). Experiencia y resultados iniciales del Hospital Regional de Talca

Tapia

et al. 2018

Rev Chil Cir

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Introduction: Postoperative liver failure (POLF) is a relevant cause of morbimortality after liver surgery. An insufficient future liver remnant (FLR) is one of the main causes of POLF. The association of hepatic bipartition with portal ligation for 2-stage hepatectomy (ALPPS) is a relatively new technique that induces rapid parenchymal hypertrophy reducing the waiting time to achieve adequate FLR. Our aim is to communicate the experience and the initial results of the hepatectomy in 2-stages using the ALLPS technique. Material and Method: All patients in whom a 2-stage hepatectomy using ALPPS technique between June 1, 2014 and July 31, 2016 in the Digestive Surgery Unit of the Hospital Regional of Talca were included. Results: There were 47 hepatectomies performed at the Hospital Regional of Talca. In 3 cases (6.3%), a 2-stage hepatectomy was performed using the ALPPS technique, in all of which a hypertrophy of the future hepatic remnant (RHF) was achieved, which allowed completing the second stage without POLF clinically significant. Conclusion: In our initial experience, the ALPPS technique successfully allowed increase FLR in patients who initially had insufficient FLR to be submitted a major liver resection.

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Section: Discussionunclassified

Hepatectomía en 2 tiempos con técnica de ALPPS (Asociación de bipartición hepática con ligadura portal para hepatectomía en 2 tiempos). Experiencia y resultados iniciales del Hospital Regional de Talca

Tapia

et al. 2018

Rev Chil Cir

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show abstract

“…The preoperative volumetry showed total liver volumes of 1,840 and 1,634 cm 3 . The volume of the FLR, constituted of segment 4+1, was 255 cm 3 (patient 1) and 199 cm 3 (patient 2).…”

Section: Institutional Experiencementioning

confidence: 97%

“…Technically, the right hemiliver and the left lateral sector could not be preserved due to the involvement of the right hepatic vein and the large lesion in S2−3. The preoperative FLR volume for segments 4+1 was 199 cm 3 , 13% of total liver volume (TLV), which was deemed too small for a single stage procedure ( Figure 1). The second patient was a 61-years-old male presenting with mid rectum adenocarcinoma treated with neoadjuvant pelvic radiotherapy, chemotherapy with XELOX and anterior resection with loop ileostomy (stage pT2N1 Duke's C).…”

Section: Patientsmentioning

confidence: 99%

“…This variation of the ALPPS technique represents a substantial change to the traditional paradigm of liver resectability, which is defined as the removal of tumour with negative margins, preserving ≥2 contiguous liver segments along with their inflow, outflow and biliary drainage. Various reports and reviews have been published, describing advantages and limitations of ALPPS (1)(2)(3). ALPPS induces a rapid hypertrophy of the liver remnant compared to portal vein embolization or ligation with a rate of completion of second stage between 95% and 100%.…”

Section: Introductionmentioning

confidence: 99%

“…ALPPS induces a rapid hypertrophy of the liver remnant compared to portal vein embolization or ligation with a rate of completion of second stage between 95% and 100%. However, concerns are mainly due to the high morbidity (up to 44% of Clavien-Dindo grade III or more) and mortality rates up to 29%, as well as the possible relationship between a rapid hypertrophy and tumour progression (3). Therefore, ALPPS is still a debated topic.…”

Section: Introductionmentioning

confidence: 99%

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