Laparoscopic Partial ALPPS: Much Better Than ALPPS!

Truant, Stéphanie; Amrani, M. El; Baillet, C.; Ploquin, Anne; Lécolle, Katia; Ernst, Olivier; Hebbar, Mohamed; Huglo, D.; Pruvot, François‐René

doi:10.5604/01.3001.0012.7937

Cited by 26 publications

(21 citation statements)

References 10 publications

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“…15 Now, LLR is widely accepted as a minimally invasive way to treat resectable liver lesions. 16 In fact, LLR has been performed for the treatment of HCC, 10 , 17 , 18 metastatic liver tumors, 19 , 20 hepatic cysts, 21 , 22 and benign tumors. 15 , 23 When compared with the open hepatectomy approach, laparoscopic liver surgery is associated with lower complication rates, reduced intraoperative blood loss, and a shorter hospital stay.…”

Section: Discussionmentioning

confidence: 99%

Safely Modified Laparoscopic Liver Resection for Segment VI and/or VII Hepatic Lesions Using the Left Lateral Decubitus Position

Xiao¹,

Wang²,

Lin³

et al. 2022

IJGM

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Purpose To explore the feasibility and safety of using the left lateral decubitus position (LLDP) to perform laparoscopic liver resection (LLR) for the treatment of hepatic lesions in segment VI and/or VII. Patients and Methods Clinical data concerning 50 patients underwent LLR including 25 patients in the LLDP and the other 25 patients in the routine operative position (ROP) at Shulan (Hangzhou) Hospital Affiliated to Zhejiang Shuren University Shulan International Medical College (Hangzhou, China) and Shulan (Quzhou) Hospital between March 2019 and May 2022 were retrospectively analyzed. All of the patients underwent LLR while in the LLDP or the ROP for the treatment of hepatic lesions located in segment VI and/or VII. Results The preoperative clinical and laboratory parameters were comparable between the two groups (P > 0.05). All patients completed the surgery successfully. There were two patients required conversion to open resection in the ROP comparing with zero in the LLDP. The mean operative time was 256.9 ± 132.7 minutes in LLDP and 255.7 ± 92.1 minutes in ROP, while the median perioperative blood loss was 100 mL (range: 50–300 mL) in LLDP and 200 mL (range: 50–425 mL), respectively. The postoperative pathological examination showed that margin-negative resection was achieved all of the cases. The important postoperative parameters all returned to normal within five days after the LLR. The mean postoperative hospital stay (15.6 vs 19.3 days; p < 0.05) and the extraction of the drainage tube time (7.8 vs 10.4 days; p < 0.05) were shorter for patients in LLDP. Conclusion The LLDP represents a safe and feasible position for performing LLR in selected patients with lesions in segment VI and/or VII. LLR in the LLDP is helpful in terms of the exposure of the surgical field and the recovery of the patient.

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Section: Discussionmentioning

confidence: 99%

Safely Modified Laparoscopic Liver Resection for Segment VI and/or VII Hepatic Lesions Using the Left Lateral Decubitus Position

Xiao¹,

Wang²,

Lin³

et al. 2022

IJGM

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“…Cherqui et al 17 reported the first laparoscopic left lateral sectionectomy in living donors, in 2002. Recently, totally laparoscopic associating liver partition with portal vein ligation for staged hepatectomy (ALPPS) was reported 9,18,19 . The five sections of the guidelines (indications, patients and complex disease, procedures, technique, and implementation) were divided into subcategories 25 .…”

Section: Indications and History Of Guidelinesmentioning

confidence: 99%

Current Status of Laparoscopic Hepatectomy

et al. 2019

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Before the first laparoscopic hepatectomy (LH) was described in 1991, open hepatectomy (OH) was the only choice for surgical treatment of liver tumors. LH indications were initially based solely on tumor location, size, and type. Use of LH has spread rapidly worldwide because it reduces incision size. This review systematically assesses the current status of LH. As compared with OH, LH is significantly less complicated, requires shorter hospital stays, and results in less blood loss. The long-term survival rates of LH and OH are comparable. Development of new techniques and instruments will improve the conversion rate and reduce complications. Furthermore, development of surgical navigation will improve LH safety and efficacy. Laparoscopic major hepatectomy for HCC remains a challenging procedure and should only be performed by experienced surgeons. In the near future, a training system for young surgeons will become mandatory for standardization of LH, and LH will likely become better standardized and have broader applications.

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“…The concept of minimizing the invasiveness of stage 1 surgery further led to the development of Mini‐ALPPS, where partial parenchymal transection is combined with intraoperative PVE . Another combination of less invasive ALPPS elements is laparoscopic partial ALPPS, which results in a favorable outcome with rapid and sufficient volume growth . The rationale behind the concept of less invasiveness of stage 1 surgery is to better tolerate the interstage course while allowing rapid and sufficient hypertrophy with minimizing the risk for interstage complications.…”

Section: Technical Variants In Alppsmentioning

confidence: 99%

“…30 Another combination of less invasive ALPPS elements is laparoscopic partial ALPPS, which results in a favorable outcome with rapid and sufficient volume growth. 36 The rationale behind the concept of less invasiveness of stage 1 surgery is to better tolerate the interstage course while allowing rapid and sufficient hypertrophy with minimizing the risk for interstage complications. Remarkably, Robles et al 28 proposed a variant where parenchymal transection was replaced by the application of a tourniquet leading to a similar regenerative response.…”

Section: Technical Variants In Alppsmentioning

confidence: 99%

Dealing with insufficient liver remnant: Associating liver partition and portal vein ligation for staged hepatectomy

Linecker

Kuemmerli

Clavien

et al. 2019

Journal of Surgical Oncology

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Liver resection for colorectal liver metastases has emerged to highly successful treatment in the last decades. Key to this success is complete hepatic tumor removal and systemic disease control by chemotherapy. Associating liver partition and portal vein ligation for staged hepatectomy is the most recent two‐stage resection strategy for patients with very small future liver remnant making complete tumor removal possible within 1 to 2 weeks. Oncological outcome data are being collected at the moment and first results from small series reveal promising results.

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Laparoscopic Partial ALPPS: Much Better Than ALPPS!

Cited by 26 publications

References 10 publications

Safely Modified Laparoscopic Liver Resection for Segment VI and/or VII Hepatic Lesions Using the Left Lateral Decubitus Position

Safely Modified Laparoscopic Liver Resection for Segment VI and/or VII Hepatic Lesions Using the Left Lateral Decubitus Position

Current Status of Laparoscopic Hepatectomy

Dealing with insufficient liver remnant: Associating liver partition and portal vein ligation for staged hepatectomy

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