Associating portal embolization and artery ligation to induce rapid liver regeneration in staged hepatectomy

Dupré, Aurélien; Hitier, M.; Peyrat, Patrice; Chen, Y.; Méeus, Pierre; Rivoire, Michel

doi:10.1002/bjs.9900

Cited by 20 publications

(14 citation statements)

References 31 publications

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“…Updates in Liver Cancer FLR hypertrophy of over 100% at day 7 [38]. There were no complications related to hepatic necrosis, and the authors suggest that the avoidance of parenchymal dissection reduces the risk of bile leak and infection.…”

Section: Associating Portal Embolization and Artery Ligation (Apeal)mentioning

confidence: 93%

“…This procedure combines portal vein embolization and arterial ligation [38]. At the first stage of the procedure, the FLR is surgically mobilized as in the ALPPS procedure.…”

Section: Associating Portal Embolization and Artery Ligation (Apeal)mentioning

confidence: 99%

“…At the first stage of the procedure, the FLR is surgically mobilized as in the ALPPS procedure. The right portal vein is embolized before being ligated and divided [38]. A right sectoral hepatic artery ligation is performed (either the artery for segments V/VIII or segments VI/VII), and the segment IVb inflow is also interrupted [38].…”

Section: Associating Portal Embolization and Artery Ligation (Apeal)mentioning

confidence: 99%

“…Dupre et al [38] published their series of 10 patients who had required two-stage extended right hemihepatectomy for bilobar colorectal metastases. All the patients included had a low FLR volume and/or prolonged pre-operative chemotherapy and the procedure resulted in No stage 2 due to failure to grow% 7% 0%…”

Section: Associating Portal Embolization and Artery Ligation (Apeal)mentioning

confidence: 99%

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Assessment and Optimization of the Future Liver Remnant

Maundura¹,

Koea²

2017

Updates in Liver Cancer

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Safe liver resection is a vital element in the management of primary and secondary hepatic malignancies. The indications for resection have evolved Over time, and this has in part been due to the ability to improve the future liver remnant (FLR). This chapter reviews the current and future methods used for assessing the future liver remnant volume and function in order to minimize the risk of post-hepatectomy liver failure (PHLF). Current and evolving methods used in augmenting the future liver remnant are also considered. Since its introduction in the 1990s, portal venous embolization (PVE) has become the most widely used method of augmenting the FLR. The factors that affect hypertrophy following embolization as well as techniques used in portal venous embolization will be reviewed. Other methods of augmentation discussed include portal vein ligation (PVL) and the emerging method of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS). The chapter also considers the various methods in the context of limiting tumour progression in the future liver remnant and attempts to integrate newer techniques such as ALPPS into current treatment algorithms.

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Section: Associating Portal Embolization and Artery Ligation (Apeal)mentioning

confidence: 93%

“…This procedure combines portal vein embolization and arterial ligation [38]. At the first stage of the procedure, the FLR is surgically mobilized as in the ALPPS procedure.…”

Section: Associating Portal Embolization and Artery Ligation (Apeal)mentioning

confidence: 99%

Section: Associating Portal Embolization and Artery Ligation (Apeal)mentioning

confidence: 99%

Section: Associating Portal Embolization and Artery Ligation (Apeal)mentioning

confidence: 99%

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Assessment and Optimization of the Future Liver Remnant

Maundura¹,

Koea²

2017

Updates in Liver Cancer

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“…The combined use of chemotherapy and surgery has contributed to an increase in resectability and survival. This is based on the effective "conversion" chemotherapy agents (oxaliplatin and irinotecan) in combination with molecular targeted agents (bevacizumab and cetuximab), in association with liver remodeling strategies including portal vein ligation or embolization [13]. Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy [14], which represents a new strategy, currently remains investigational due to associated high morbidity and mortality.…”

Section: Surgery In Initially Unresectable Patientsmentioning

confidence: 99%

Recent Advances in Chemotherapy and Surgery for Colorectal Liver Metastases

et al. 2016

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Background: The liver is the most common site of metastases for colorectal cancer, and combined resection with systemic chemotherapy is the most effective strategy for survival. The aim of this article is to provide a comprehensive summary on four hot topics related to chemotherapy and surgery for colorectal liver metastases (CLM), namely: (1) chemotherapy-related liver injuries: prediction and impact, (2) surgery for initially unresectable CLM, (3) the emerging role of RAS mutations, and (4) the role of hepatic arterial infusion of chemotherapy (HAIC). Summary and Key Messages: (1) The use of chemotherapy before liver resection for CLM leads to drug-specific hepatic toxicity, which negatively impacts posthepatectomy outcomes. (2) Curative liver resection of initially unresectable CLM following conversion chemotherapy should be attempted whenever possible, provided that a safe future liver remnant volume is achieved. (3) For CLM, RAS mutation status is needed to guide the use of targeted chemotherapy with anti-epithelial growth factor receptor (EGFR) agents, and is a major prognostic factor that may contribute to optimize surgical strategy. (4) HAIC agents increase the rate of objective response and the rate of complete pathological response.

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