Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS): Short-term outcome, functional changes in the future liver remnant, and tumor growth activity

Tanaka, Kuniya; Matsuo, Keitaro; Murakami, Takashi; Kawaguchi, Daisuke; Hiroshima, Yukihiko; Koda, Keiji; Endo, Itaru; Ichikawa, Yasushi; Taguri, Masataka; Tanabe, Mikiko

doi:10.1016/j.ejso.2015.01.031

Cited by 94 publications

(96 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In patient presented above, the ratio of FLR hypertrophy was 98% at 11 days, significantly higher than those reported with PVL. The higher hypertrophy ratio achieved by ALPPS procedure in the patient presented above is similar to those reported by other authors (22)(23)(24), who revealed a statistically significant increase in FLR volume after ALPPS than in patients undergoing PVE/PVL, allowing the performance of R0 resections in almost 100% of patients subjected to this new approach (25,26). Moreover, recent studies revealed that in patients who failed to achieve sufficient FLR hypertrophy after PVE, the performance of ALPPS was an effective strategy, able to induce a FLR gain which allowed subsequent R0 resection (26;27).…”

Section: Discussion Discussionsupporting

confidence: 90%

“…A multicentric analysis revealed an 11-fold faster hypertrophy after ALPPS than after PVE (28). As hypertrophy is achieved more rapidly after ALPPS, the complete resection of the tumor could be performed in a shorter period of time, which offers some benefits: 1. the risk of disease progression between the two stages of the operation decreases (25,29); 2. the patient recovers more rapidly, decreasing the length of hospital stay (25); 3. the postoperative chemotherapy could be delivered sooner than in patients undergoing "twostage" operations (25).…”

Section: Discussion Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Primary Hepatic Lymphoma Resected by ALPPS Procedure (Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy)

Alexandrescu¹,

Stoica²,

Grigorie³

et al. 2016

JTMR

View full text Add to dashboard Cite

Background: Primary hepatic lymphoma represents a very rare location of non-Hodgkin lymphomas, whose treatment consists of liver tumor resection followed by chemotherapy. In some cases, however, upfront hepatectomy is not feasible due to insufficient volume of the liver remnant. Case report: An ALPPS (Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy) procedure was performed in a patient with a large primary hepatic lymphoma, whose estimated liver remnant represented only 13% of total liver volume, it was performed. During the first stage, we performed right portal branch ligation and in situ splitting, without right bile duct ligation. After the first stage, the patient did not develop biliary fistula, ascites or sepsis. The volume of segments 2 and 3 increased by 98% after eleven days, making possible subsequent resection of the tumor by a right trisectionectomy. The patient did not develop any complication, being discharged 9 days after the second stage of ALPPS. Postoperatively, the patient underwent chemotherapy, being disease-free at 13 months following operation. Conclusion: This is the first patient presented in the literature who underwent ALPPS for resection of a primary hepatic lymphoma. This type of tumor could be managed by ALPPS, with low morbidity and mortality rates. Abbreviations: ALPPS -Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy, PHL -primary hepatic lymphoma, PVE -portal vein embolization, PVL -portal vein ligation, FLR -future liver remnant

show abstract

Section: Discussion Discussionsupporting

confidence: 90%

Section: Discussion Discussionmentioning

confidence: 99%

Primary Hepatic Lymphoma Resected by ALPPS Procedure (Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy)

Alexandrescu¹,

Stoica²,

Grigorie³

et al. 2016

JTMR

View full text Add to dashboard Cite

show abstract

“…Se trata mayoritariamente de series pequeñas, inferiores a 50 pacientes (con varias de ellas menores de 20 casos); con excepción de una que agrupa varios centros, llegando a 202 casos (Schadde et al, 2014b) Adam et al ., 2016;Björnsson et al ., 2016b); gran parte de la cual es ≥ a grado IIIB de Clavien-Dindo (Clavien et al, 2009;Nadalin et al;Tanaka et al, 2015). Cuando se requiere realizar reconstrucciones biliares, por colangiocarcinoma hiliares, la morbilidad puede incluso ser mayor (Schnitzbauer et al; Li et al; Nadalin et al).…”

Section: Resultsunclassified

“…Pero, además, se ha reportado mortalidad tardía (posterior a los 90 días), la que puede llegar a 12,8 % Rochet et al;Lang et al;Tanaka et al, 2015;Björnsson et al, 2016b). Últimamente, se desarrolló un escore predictivo de riesgo de mortalidad postoperatorio inmediata y a 90 días, con base en un análi-sis multivariado (Linecker et al, 2016 Comparación con la hepatectomía convencional de dos etapas: Existe evidencia escasa respecto de este punto.…”

Section: Resultsunclassified

Asociación de Partición Hepática y Ligadura Portal para Hepatectomía por Etapas (ALPPS)

Manterola

Otzen

2017

Int. J. Morphol.

View full text Add to dashboard Cite

MANTEROLA, C. & OTZEN, T.Asociación de partición hepática y ligadura portal para hepatectomía por etapas (ALPPS). Int. J. Morphol., 35(3):1083Morphol., 35(3): -1090Morphol., 35(3): , 2017. RESUMEN:La disfunción hepática postoperatoria del remanente hepático que ocurre en pacientes sometidos a grandes resecciones hepáticas, es un problema complejo y temido, dado su pronóstico incierto. La asociación de partición hepática y ligadura portal para hepatectomía por etapas (ALPPS), es un enfoque novedoso para pacientes portadores de enfermedad hepática oncológica que anteriormente eran considerados "no resecables". El procedimiento se realiza en dos etapas. La primera, comprende la ligadura de la rama derecha de la vena porta. Luego, se realiza la transección del parénquima hepático; incluyendo o no, la sección y ligadura de la vena hepática media. A continuación se empaqueta el hígado tumoral en una bolsa de polietileno y el abdomen es cerrado. La segunda etapa, se realiza 7 a 15 días después. Una vez abierto el abdomen, se retira la bolsa de polietileno; se ligan y seccionan la arteria, el conducto biliar y la vena hepática derechos; y se elimina el hígado tumoral. Pueden instalarse drenes y se procede al cierre de la laparotomía. La técnica ALPPS puede permitir entonces, la resección curativa de hígados tumorales en pacientes con lesiones considerados previamente como no resecables. El objetivo de este artículo fue describir las indicaciones y aspectos técnicos del ALPPS a propósito del primer caso realizado en nuestra ciudad, en una paciente de 47 años con un cáncer de vesícula biliar avanzado y metástasis bilobares.PALABRAS CLAVE: Neoplasia hepática; Metástasis hepáticas; Hígado metastásico; Hepatectomías; Trisegmentectomía derecha; Cáncer de la vesícula biliar; Insuficiencia hepática aguda; Ligadura de la vena porta; Regeneración hepática; ALPPS.

show abstract

“…Tanaka has suggested that we should be cautious as functional changes in the FLR lag behind changes in volume. 8 My own opinion is that we should indeed wait longer and I suggest that surgeons should consider that a "delayed ALPPS" approach is safer: in my experience a wait time of 14 days does not increase operative difficulty and it carries with it the benefit of easy scheduling, whilst allowing the patient some time at home between stages. We also know that successful outcomes are possible with "rescue ALPPS" for patients that have previously failed to achieve adequate FLR hypertrophy with portal vein embolisation.…”

Section: Accepted Manuscriptmentioning

confidence: 91%

ALPPS: The argument for

Lodge

2017

European Journal of Surgical Oncology (EJSO)

View full text Add to dashboard Cite

Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS): Short-term outcome, functional changes in the future liver remnant, and tumor growth activity

Cited by 94 publications

References 19 publications

Primary Hepatic Lymphoma Resected by ALPPS Procedure (Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy)

Primary Hepatic Lymphoma Resected by ALPPS Procedure (Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy)

Asociación de Partición Hepática y Ligadura Portal para Hepatectomía por Etapas (ALPPS)

ALPPS: The argument for

Contact Info

Product

Resources

About