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ALPPS procedure

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https://www.readbyqxmd.com/read/29344520/did-the-international-alpps-meeting-2015-have-an-impact-on-daily-practice-the-hamburg-barmbek-experience-of-58-cases
#1
Gregor A Stavrou, Marcello Donati, Mohammad H Fard-Aghaie, Martin Zeile, Tessa M Huber, Axel Stang, Karl J Oldhafer
Background: ALPPS (associating liver partition and portal vein ligation for staged hepatectomy) was introduced only 10 years ago and has gained wide acceptance as a variation of staged procedures in liver surgery. It has been criticized for its high morbidity and mortality, which all centers reported in their initial series. Methods: After a world expert meeting in Hamburg in 2015 where all experts in the field met to discuss this method, caveats were extracted and formulated...
December 2017: Visceral Medicine
https://www.readbyqxmd.com/read/29344517/a-comparison-of-pitfalls-after-alpps-stage-1-or-portal-vein-embolization-in-small-for-size-setting-hepatectomies
#2
REVIEW
Andreas A Schnitzbauer
Background: Portal vein embolization (PVE) followed by resection and associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) are tools to enable liver resections in small-for-size settings. Methods: A systematic review of the literature and comparison of pitfalls between PVE and resection and after ALPPS stage 1 were performed. Results: Evidence levels were as low as 4 for both procedures. 20 publications were identified with reports on post-PVE or post-ALPPS stage 1 pitfalls...
December 2017: Visceral Medicine
https://www.readbyqxmd.com/read/29318366/-surgical-innovations-in-treatment-of-metastatic-colorectal-cancer-complexity-of-metastatic-surgery-as-example-for-personalized-medicine
#3
REVIEW
C Hackl, S M Brunner, K M Schmidt, H J Schlitt
BACKGROUND: Extensive, bilobular and multifocal colorectal liver metastases (CLM) or metastases that are critically situated require an experienced surgeon and advanced surgical techniques to enable curative resection. OBJECTIVE: This article describes the toolbox of hepato-oncologic surgery including functional augmentation of liver segments by portal vein embolization/ligation, combinations of ablation and resection, two-stage resections and in situ split liver resection, also known as associating liver partition and portal vein ligation for staged hepatectomy (ALPPS)...
January 9, 2018: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/29279592/rapidly-increasing-liver-progenitor-cell-numbers-in-human-regenerating-liver-after-portal-vein-ligation-and-liver-partition
#4
K H Lin, H T Hsu, T H Teng, P Y Lin, C J Ko, C E Hsieh, Y L Chen
BACKGROUND: Liver regeneration is dependent on the proliferation of hepatocytes. Hepatic progenitor cells are intra-hepatic precursor cells capable of differentiating into hepatocytes or biliary cells. Although liver progenitor cell proliferation during the regenerative process has been observed in animal models of severe liver injury, it has never been observed in vivo in humans because it is unethical to take multiple biopsy specimens for the purpose of studying the proliferation of liver progenitor cells and the roles they play in liver regeneration...
December 2017: Malaysian Journal of Pathology
https://www.readbyqxmd.com/read/29239077/high-incidence-of-biliary-stricture-after-associating-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy
#5
Srinivas Sanjeevi, Ernesto Sparrelid, Stefan Gilg, Eduard Jonas, Bengt Isaksson
BACKGROUND: Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is a two-stage procedure most frequently applied in the setting of an extended right-sided hemi-hepatectomy. Initial reports of high mortality have sparked debate regarding the safety and efficacy of the procedure. We describe a higher incidence of early post-operative bile duct strictures after ALPPS, a complication rarely seen after conventional liver resection. METHODS: An institutional review was conducted to assess the incidence of post-operative biliary strictures following conventional right-sided or extended right-sided hemi-hepatectomy and ALPPS...
December 14, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29198493/impact-of-associating-liver-partition-and-portal-vein-occlusion-for-staged-hepatectomy-on-tumor-growth-in-a-mouse-model-of-liver-metastasis
#6
Yutaro Kikuchi, Yukihiko Hiroshima, Kenichi Matsuo, Takashi Murakami, Daisuke Kawaguchi, Kohei Kasahara, Kuniya Tanaka
BACKGROUND: The impact of associating liver partition and portal vein occlusion for staged hepatectomy (ALPPS) on tumor growth activity was investigated. METHODS: A BALB/c mouse model (male, 8-10 weeks old) of liver metastasis labeled by red fluorescent protein was established. Changes in future liver remnant (FLR) volumes, tumor growth activity, and levels of cytokines and growth factors in liver tissues during the treatment period were compared among the models involving ALPPS, portal vein ligation (PVL), or sham operation...
November 23, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29173259/optimizing-associated-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy-outcomes-surgical-experience-or-appropriate-patient-selection
#7
COMPARATIVE STUDY
Ibrahim Al Hasan, Mauro Enrique Tun-Abraham, Kerollos N Wanis, Carlos Garcia-Ochoa, Mark A Levstik, Bandar Al-Judaibi, Roberto Hernandez-Alejandro
BACKGROUND: Early reports of associated liver partition and portal vein ligation for staged hepatectomy (ALPPS) outcomes have been suboptimal. The literature has confirmed that learning curves influence surgical outcomes. We have 54 months of continuous experience performing ALPPS with strict selection criteria. This study aimed to evaluate the impact of the learning curve on ALPPS outcomes. METHODS: We retrospectively compared patients who underwent ALPPS between April 2012 and March 2016...
December 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29137004/the-principle-of-preserving-outflow-structures-in-partial-alpps-a-commentary-on-segment-4-a-key-point-of-alpps-procedure
#8
LETTER
Henrik Petrowsky, Pierre-Alain Clavien
No abstract text is available yet for this article.
December 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29137003/segment-4-a-key-point-of-alpps-procedure
#9
Giuseppe Maria Ettorre, Nicola Guglielmo, Roberto Luca Meniconi, Giovanni Battista Levi Sandri, Marco Colasanti, Giovanni Vennarecci
No abstract text is available yet for this article.
December 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28990002/two-cases-of-alpps-procedure-simultaneous-alpps-and-colorectal-resection-and-alpps-procedure-for-hepatic-malignancy-larger-than-15-centimeter
#10
Young Il Choi, Hyung Hwan Moon, Dong Hoon Shin
Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has recently been introduced as a new surgical technique to increase future liver remnant in patients with marginal liver volume contemplating major liver resection. We herein present two cases. Case 1: a 68-year-old male patient with colorectal liver metastasis was referred to our department. The future liver remnant (FLR) was 22%. We performed first-stage ALPPS and colorectal surgery concurrently and second stage operation was performed 8 days later...
August 2017: Annals of Hepato-Biliary-Pancreatic Surgery
https://www.readbyqxmd.com/read/28941575/bioenergetic-adaptations-of-the-human-liver-in-the-alpps-procedure-how-liver-regeneration-correlates-with-mitochondrial-energy-status
#11
Henrique Alexandrino, Anabela Rolo, João S Teodoro, Henrique Donato, Ricardo Martins, Marco Serôdio, Mónica Martins, José G Tralhão, Filipe Caseiro Alves, Carlos Palmeira, Francisco Castro E Sousa
BACKGROUND: The Associating Liver Partition and Portal Ligation for Staged Hepatectomy (ALPPS) depends on a significant inter-stages kinetic growth rate (KGR). Liver regeneration is highly energy-dependent. The metabolic adaptations in ALPPS are unknown. AIMS: i) Assess bioenergetics in both stages of ALPPS (T1 and T2) and compare them with control patients undergoing minor (miHp) and major hepatectomy (MaHp), respectively; ii) Correlate findings in ALPPS with volumetric data; iii) Investigate expression of genes involved in liver regeneration and energy metabolism...
September 20, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28917644/alpps-as-a-salvage-procedure-after-insufficient-future-liver-remnant-hypertrophy-following-portal-vein-occlusion
#12
Marcelo Enne, Erik Schadde, Bergthór Björnsson, Roberto Hernandez Alejandro, Klaus Steinbruck, Eduardo Viana, Ricardo Robles Campos, Massimo Malago, Pierre-Alain Clavien, Eduardo De Santibanes, Brice Gayet
BACKGROUND: A minimum future liver remnant (FLR) of 30% is required to avoid post hepatectomy liver failure (PHLF). Portal vein occlusion (PVO) is the main strategy to induce hypertrophy of the FLR, but some patients will not reach sufficient FLR hypertrophy to enable resection. Recently ALPPS has emerged as a "Salvage Procedure" for PVO failure. The aim of this study was to report the short term outcomes of ALPPS following PVO failure. METHODS: A retrospective analysis of patients enrolled within the international ALPPS Registry between October 2012 and November 2015 (NCT01924741) was performed...
September 13, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28861759/diffusion-outcomes-and-implementation-of-minimally-invasive-liver-surgery-a-snapshot-from-the-i-go-mils-italian-group-of-minimally-invasive-liver-surgery-registry
#13
Luca Aldrighetti, Francesca Ratti, Umberto Cillo, Alessandro Ferrero, Giuseppe Maria Ettorre, Alfredo Guglielmi, Felice Giuliante, Fulvio Calise
The Italian Group of MILS (I Go MILS) prospective registry was established in 2014 with the goals to create a hub for data and projects on a national basis and to promote the diffusion and implementation of MILS programs on a national scale. The primary endpoint of the present study is to give a snapshot of the real diffusion and outcomes of MILS in Italy, while analyzing the role of the registry in the implementation of MILS programs nationwide. The I Go MILS Registry is a prospective and intention-to-treat registry opened to any Italian center performing MILS, without restriction criteria based on number of procedures...
September 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28844397/functional-considerations-in-alpps-consequences-for-clinical-management
#14
Martin Stockmann, Jan Bednarsch, Maciej Malinowski, Elisabeth Blüthner, Johann Pratschke, Daniel Seehofer, Maximilian Jara
BACKGROUND: Since perioperative morbidity and mortality in ALPPS are extraordinarily high, a deeper understanding of actual liver function during the procedure is essential to make the approach safer. METHODS: Data from 17 patients who underwent ALLPS were analyzed regarding their course of liver function capacity assessed with the LiMAx test and compared to an equal-sized matched cohort of patients that underwent PVE. RESULTS: A comparison of LiMAx prior to and following ALPPS Step I (330 [258-385] vs...
November 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28829432/rat-model-of-the-associating-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy-alpps-procedure
#15
Erik Schadde, Martin Hertl, Stefan Breitenstein, Beatrice Beck-Schimmer, Martin Schläpfer
Recent clinical data support an aggressive surgical approach to both primary and metastatic liver tumors. For some indications, like colorectal liver metastases, the amount of liver tissue left behind after liver resection has become the main limiting factor of resectability of large or multiple liver tumors. A minimal amount of functional tissue is required to avoid the severe complication of post-hepatectomy liver failure, which has high morbidity and mortality. Inducing liver growth of the prospective remnant prior to resection has become more established in liver surgery, either in the form of portal vein embolization by interventional radiologists or in the form of portal vein ligation several weeks prior to resection...
August 14, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28795384/contribution-of-hepatobiliary-scintigraphy-in-assessing-alpps-most-suited-timing
#16
Stéphanie Truant, Clio Baillet, Anne Claire Deshorgue, Mehdi El Amrani, Damien Huglo, François-René Pruvot
To reduce post-hepatectomy liver failure (PHLF), associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has been recently developed for patients with a limited future remnant liver (FRL). Nevertheless, high morbi-mortality rates have been reported . The current study aimed to analyze the kinetics of FRL function in patients who were offered ALPPS. Serial SPECT (99 m)Tc-mebrofenin hepatobiliary scintigraphy (HBS) was performed in all patients before and after surgery as well as at inter-stage to quantitatively assess hepatic function [total liver (TL) and FRL]...
September 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28689487/the-alpps-in-the-treatment-of-hepatitis-b-related-hepatocellular-carcinoma-with-cirrhosis-a-single-center-study-and-literature-review
#17
Xiujun Cai, Yifan Tong, Hong Yu, Xiao Liang, Yifan Wang, Yuelong Liang, Zheyong Li, Shuyong Peng, W Y Lau
BACKGROUND: Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has been reported to be a new treatment strategy for patients with predicted small volumes of future liver remnant (FLR). ALPPS is associated with rapid hypertrophy of FLR but it has a high postoperative mortality and morbidity. Up to now, it is controversial to apply ALPPS in hepatocellular carcinoma, especially for patients with liver cirrhosis. METHODS: Between May 2014 and June 2015, consecutive patients who underwent ALPPS with hepatitis B-related hepatocellular carcinoma with cirrhosis carried out in our center were included into the study...
August 2017: Surgical Innovation
https://www.readbyqxmd.com/read/28675369/good-to-know-the-alpps-procedure-embracing-a-new-technique
#18
George-Andrei Popescu, Sorin Tiberiu Alexandrescu, Razvan Tudor Grigorie, Luminiţa Stoica, Cristian Alexandru Apavaloaie, Doina Hrehoreţ
BACKGROUND: Hepatic resection is the only potentially curative treatment for primary liver tumors and hepatic metastases. The most frightening postoperative complication of extensive hepatectomies is liver failure due to insufficient future liver remnant (FLR). The ALPPS technique (Associating Liver Partition and Portal vein Ligation for Staged hepatectomy) effectively increased the resectability of otherwise inoperable liver tumors (primary or secondary malignant liver tumor) by achieving a rapid and an effective hypertrophy of the FLR, which lowers postoperative liver failure risk...
May 2017: Chirurgia
https://www.readbyqxmd.com/read/28652892/abdominal-cross-sectional-imaging-of-the-associating-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy-procedure
#19
REVIEW
Michele Zerial, Dario Lorenzin, Andrea Risaliti, Chiara Zuiani, Rossano Girometti
Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is a recently introduced technique aimed to perform two-stage hepatectomy in patients with a variety of primary or secondary neoplastic lesions. ALPSS is based on a preliminary liver resection associated with ligation of the portal branch directed to the diseased hemiliver (DH), followed by hepatectomy after an interval of time in which the future liver remnant (FLR) hypertrophied adequately (partly because of preserved arterialization of the DH)...
June 8, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28616760/liver-segmentation-indications-techniques-and-future-directions
#20
REVIEW
Akshat Gotra, Lojan Sivakumaran, Gabriel Chartrand, Kim-Nhien Vu, Franck Vandenbroucke-Menu, Claude Kauffmann, Samuel Kadoury, Benoît Gallix, Jacques A de Guise, An Tang
OBJECTIVES: Liver volumetry has emerged as an important tool in clinical practice. Liver volume is assessed primarily via organ segmentation of computed tomography (CT) and magnetic resonance imaging (MRI) images. The goal of this paper is to provide an accessible overview of liver segmentation targeted at radiologists and other healthcare professionals. METHODS: Using images from CT and MRI, this paper reviews the indications for liver segmentation, technical approaches used in segmentation software and the developing roles of liver segmentation in clinical practice...
August 2017: Insights Into Imaging
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