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ALPPS procedure

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https://www.readbyqxmd.com/read/28493147/modified-alpps-procedures-more-safety-through-less-invasive-surgery
#1
REVIEW
Kuniya Tanaka
PURPOSE: Although associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has been advocated for treating advanced liver tumors, increased morbidity and mortality remain serious problems. Many modified procedures have been devised to improve patient safety, but some confusion persists as to benefits and risks. METHODS: Modifications to ALPPS as originally reported were reviewed to clarify their contributions to safety and their clinical relevance...
May 10, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28451728/-laparoscopic-liver-resection
#2
M R Schön, C Justinger
Laparoscopic liver surgery has become an established procedure in the treatment of liver tumors. Due to its short-term and long-term advantages, the number of centers with experience in laparoscopic liver surgery has greatly increased in the last few years. The complexity of the interventions performed has nearly reached the level of open surgery. This article describes the importance of laparoscopic hepatic surgery and discusses the evidence for the procedure. In addition, the indications for the most frequently resected tumors, metastases of colorectal cancer and hepatocellular carcinoma are explained together with important aspects of certain tumor localizations...
April 27, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28447055/associating-liver-partition-and-portal-vein-ligation-for-bleeding-hepatocellular-carcinoma-in-hbv-cirrhosis-a-safety-strategy
#3
Giovanni Battista Levi Sandri, Giovanni Vennarecci, Pasquale Lepiane, Giuseppe Maria Ettorre
The incidence of hepatocellular carcinoma (HCC) spontaneous tumor rupture varies between 3% and 26%. For resectable HCC ruptures, emergency hepatectomy or staged hepatectomy after transcatheter arterial embolization (TAE) are life-saving procedures, and efficient therapeutic methods. We report a multimodal therapy including TAE, associating liver partition and portal vein ligation (ALPPS) and immunoglobuline infusion for a huge bleeding HCC with portal vein tumor thrombosis (PVTT) in hepatitis B virus (HBV) cirrhosis...
2017: Translational Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28429054/variables-affecting-maximum-urethral-closure-pressure-mucp-and-abdominal-leak-point-pressure-alpp-measurements
#4
Bryan J Hill, Sarah Fletcher, Jeffrey Blume, Rony Adam, Renée Ward
INTRODUCTION AND HYPOTHESIS: The relationship between pelvic floor muscles and measurements of urethral function is not well studied. It is not known whether adjusting for clinical, demographic and urodynamic parameters would improve the association between MUCP and ALPP. Our hypothesis was that pelvic floor muscle strength (PFMS) influences the relationship between MUCP and ALPP. METHODS: This was a retrospective study of women who underwent a complex urodynamic study with evaluation of MUCP and ALPP using ICD-9 codes with documentation of PFMS...
April 20, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28419692/associating-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy-after-pre-operative-chemotherapy
#5
Florian W R Vondran, Felix Oldhafer, Kristina I Ringe, Thomas C Wirth, Moritz Kleine, Mark D Jäger, Juergen Klempnauer, Hueseyin Bektas
BACKGROUND: Recently a procedure termed 'Associating Liver Partition and Portal vein ligation for Staged hepatectomy' (ALPPS) was developed to increase the resectability of marginally resectable or locally unresectable liver tumours. This study focused on the application of ALPPS in patients with advanced colorectal liver metastases (CRLM) and pre-operative chemotherapy, with the aim to investigate whether the latter still allows for sufficient hypertrophy of the future liver remnant (FLR) following the first step of ALPPS...
April 16, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28417185/combined-preoperative-portal-and-hepatic-vein-embolization-biembolization-to-improve-liver-regeneration-before-major-liver-resection-a-preliminary-report
#6
Bertrand Le Roy, Antoine Perrey, Mikael Fontarensky, Johan Gagnière, Armand Abergel, Bruno Pereira, Celine Lambert, Louis Boyer, Denis Pezet, Pascal Chabrot, Emmanuel Buc
BACKGROUND: Insufficient volume of the future liver remnant (FLR) is a major cause of non-resectable disease in patients presenting with primary or metastatic liver tumours. The objective of this study was to evaluate the safety and efficacy of the combined preoperative portal and hepatic vein embolization (biembolization) before extended right liver resections. METHODS: This retrospective study was performed in a tertiary centre between 2014 and 2015. Combined right portal and hepatic vein embolization (biembolization) was proposed, as an alternative to ALPPS procedure, for all patients with primary or metastatic liver tumour, before right extended hepatectomy...
April 17, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28408101/a-new-technique-for-accelerated-liver-regeneration-an-experimental-study-in-rats
#7
Kasper Jarlhelt Andersen, Anders Riegels Knudsen, Betina Norman Jepsen, Michelle Meier, Anders Patrik Alexander Gunnarsson, Uffe Birk Jensen, Jens Randel Nyengaard, Stephen Hamilton-Dutoit, Frank Viborg Mortensen
BACKGROUND: Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is used to accelerate growth of the future liver remnant. We investigated alternative methods for increasing the future liver remnant. METHODS: A total of 152 rats were randomized as follows: (1) sham; (2) portal vein ligation; (3) portal vein ligation/surgical split (ALPPS); (4) portal vein ligation/split of the liver with a radiofrequency ablation needle; (5) portal vein ligation/radiofrequency ablation of the deportalized liver (portal vein ligation/radiofrequency ablation necrosis in the deportalized liver); (6) portal vein ligation/radiofrequency ablation of the future liver remnant (portal vein ligation/radiofrequency ablation-future liver remnant); and (7) controls...
April 10, 2017: Surgery
https://www.readbyqxmd.com/read/28381377/current-technical-aspects-of-oncological-hepatic-surgery
#8
Ahmed I Salem, Emily R Winslow
BACKGROUND: With the recent advances in oncological hepatic surgery, major liver resections became more widely utilized procedures. The era of modern hepatic surgery witnessed improvements in patients care in preoperative, intraoperative and postoperative aspects. This significantly improved surgical outcomes regarding morbidity and mortality. This review article focuses on the recent advances in oncological hepatic surgery. DATA SOURCES: This review includes only data from peer-reviewed articles and journals...
April 2017: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/28288067/modified-associating-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy-for-hepatoblastoma-in-a-small-infant-how-far-can-we-push-the-envelope
#9
Johnny C Hong, Joohyun Kim, Meghen Browning, Amy Wagner, Stacee Lerret, Annette D Segura, Michael A Zimmerman
For patients with hepatoblastoma, a timely and complete resection of the tumor is critical to the patient's tumor recurrence-free survival. Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS), a 2-stage hepatectomy procedure, has revolutionized the surgical management of large hepatic tumors with insufficient future liver remnant (FLR) at presentation. Although existing data support the utility of ALPPS in adults with primary and metastatic hepatobiliary malignancy, the literature in children is scarce...
March 10, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28266972/laparoscopy-in-alpps-procedure-when-we-can-do-it
#10
Pablo Barros Schelotto, Gabriel Gondolesi
No abstract text is available yet for this article.
April 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28119254/associating-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy-the-current-role-and-development
#11
Wan Yee Lau, Eric Ch Lai, Stephanie Hy Lau
BACKGROUND: Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has recently been developed to induce rapid liver hypertrophy and reduce post-hepatectomy liver failure in patients with insufficient future liver remnant (FLR). ALPPS is still considered to be in an early developmental phase because surgical indications and techniques have not been standardized. This article aimed to review the current role and future developments of ALPPS. DATA SOURCES: Studies were identified by searching MEDLINE and PubMed for articles from January 2007 to October 2016 using the keywords "associating liver partition and portal vein ligation for staged hepatectomy" and "ALPPS"...
February 2017: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/28059974/modified-alpps-procedures-avoiding-division-of-portal-pedicles
#12
Ricardo Robles-Campos, Roberto Brusadin, Asunción López-Conesa, Pascual Parrilla
No abstract text is available yet for this article.
February 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28032566/rabbit-model-provides-new-insights-in-liver-regeneration-after-transection-with-portal-vein-ligation
#13
Mingheng Liao, Tao Zhang, Haichuan Wang, Ying Liu, Minxun Lu, Jiwei Huang, Yong Zeng
BACKGROUND: The rabbit model of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has not been reported before. MATERIALS AND METHODS: New Zealand white rabbits were allocated to two protocols. Protocol 1 involved either liver parenchymal transection (LPT, n = 5) or portal vein ligation (PVL, n = 5). Protocol 2 involved the ligation of different portal vein branches combined with liver partition, including the LPT + 20% PVL group (n = 5; the caudate portal vein was ligated), the LPT + 50% PVL group (n = 5; the left portal vein was ligated), and the LPT + 70% PVL group (n = 10; both veins were ligated)...
November 2, 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27995092/surgery-of-colorectal-liver-metastases-pushing-the-limits
#14
REVIEW
Guido Torzilli, René Adam, Luca Viganò, Katsunori Imai, Jeremias Goransky, Andrea Fontana, Christian Toso, Pietro Majno, Eduardo de Santibañes
BACKGROUND: The recent advent of more effective chemotherapy and the development of surgical procedures have expanded the pool of resectable patients with colorectal liver metastases (CLM). Two-stage hepatectomy (TSH), associated liver partition and portal vein ligation for staged hepatectomy (ALPPS), and ultrasound-guided enhanced one-stage hepatectomy (e-OSH) are the surgical solutions proposed for these patients, but the range of indications for these procedures vary from institution to institution...
November 2016: Liver Cancer
https://www.readbyqxmd.com/read/27826578/early-multifocal-recurrence-of-hepatoblastoma-in-the-residual-liver-after-r0-liver-resection-with-alpps-procedure-a-case-report
#15
Abid Q Qazi, Aamir Ali Syed, Ahsun W Khan, Faisal Hanif
Associated liver partition and portal vein ligation for staged hepatectomy (ALPPS) has been successfully employed in adults to avoid potential liver insufficiency in patient with small future liver volume (FLV) when subjected to conventional right trisectionectomy. We are reporting an infant with hepatoblastoma, who underwent a technically successful ALPPS procedure with R0 resection. However he developed very early recurrence within the first month after the procedure. We present this report with a view to share our unexpected finding of early multifocal recurrence of hepatoblastoma in the residual liver after ALPPS procedure in a very young patient...
October 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/27816312/transition-from-open-to-laparoscopic-alpps-for-patients-with-very-small-flr-the-initial-experience
#16
Marcel A C Machado, Fábio F Makdissi, Rodrigo C Surjan, Tiago Basseres, Erik Schadde
BACKGROUND: Laparoscopic ALPPS (Associating Liver Partition and Portal vein ligation for Staged hepatectomy) has previously been reported but has been the authors' default option since 2015 in patients with small future liver remnant. METHODS: A retrospective analysis of all consecutive patients undergoing ALPPS at a single referral center was performed using a prospective database from July 2011 to June 2016. Feasibility was studied by assessing conversions. The 90-day mortality and complications were analyzed using a Dindo-Clavien score and the comprehensive complication index...
January 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27766595/a-literature-review-of-associating-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy-alpps-so-far-so-good
#17
REVIEW
Martin de Santibañes, Luis Boccalatte, Eduardo de Santibañes
Recently, associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) emerged as a novel surgical strategy to induce a rapid and large hypertrophy of the future liver remnant (FLR). We conducted a computerized search using PubMed and Google Scholar for reports published between March 2012 and July 2016 using mesh headings and key words relating to the ALPPS surgical procedure. The promising results obtained up to date are difficult to interpret due to the heterogeneous group of patients with different underlying pathologies and different chemotherapy schemes...
March 2017: Updates in Surgery
https://www.readbyqxmd.com/read/27761713/rescue-alpps-is-efficient-and-safe-after-failed-portal-vein-occlusion-in-patients-with-colorectal-liver-metastases
#18
Ernesto Sparrelid, Stefan Gilg, Torkel B Brismar, Lars Lundell, Bengt Isaksson
PURPOSE: The aim of this study was to investigate whether associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) can be used as an effective and safe rescue procedure in patients with colorectal liver metastases (CRLM) and insufficient effect on the future liver remnant (FLR) after previous portal vein occlusion (PVO). METHODS: Eleven patients with bilobar CRLM treated with neoadjuvant chemotherapy and previous PVO with insufficient effect on the FLR were analyzed retrospectively from a prospective database...
February 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/27756893/first-left-hepatic-trisectionectomy-including-segment-one-with-new-associated-liver-partition-and-portal-vein-ligation-with-staged-hepatectomy-alpps-modification-how-to-do-it
#19
Aiman Obed, Anwar Jarrad, Abdalla Bashir
BACKGROUND Associated Liver Partition and Portal vein ligation with Staged hepatectomy (ALPPS) leads to rapid hepatic hypertrophy and decreases incidence of post-hepatectomy liver failure in patients with a marginal future liver remnant. Various procedural ALPPS modifications were previously described. Here, we present the first case of a new ALPPS modification, carrying out a left hepatic trisectionectomy with segment 1. CASE REPORT We present the case of a 36-year-old woman with locally advanced sigmoid adeno-carcinoma and extensive left liver metastases extending to segment V and VIII, who received state-of-the-art systemic conversion chemotherapy...
October 19, 2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/27734177/total-laparoscopic-reversal-alpps
#20
M A Machado, R Surjan, T Basseres, F Makdissi
BACKGROUND: Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) allows R0 resection even for patients with extremely small future liver remnants. The ALPPS procedure was initially described for two-stage right trisectionectomy. Reversal ALPPS is a denomination in which the future liver remnant is the right posterior section of the liver. PATIENT: A 42-year-old woman with colorectal metastases in all segments except segment 1 underwent chemotherapy with objective response and was referred for surgical treatment...
April 2017: Annals of Surgical Oncology
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