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https://www.readbyqxmd.com/read/28917644/alpps-as-a-salvage-procedure-after-insufficient-future-liver-remnant-hypertrophy-following-portal-vein-occlusion
#1
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/28902669/alpps-improves-resectability-compared-with-conventional-two-stage-hepatectomy-in-patients-with-advanced-colorectal-liver-metastasis-results-from-a-scandinavian-multicenter-randomized-controlled-trial-ligro-trial
#2
Per Sandström, Bård I Røsok, Ernesto Sparrelid, Peter N Larsen, Anna L Larsson, Gert Lindell, Nicolai A Schultz, Bjorn A Bjørnbeth, Bengt Isaksson, Magnus Rizell, Bergthor Björnsson
OBJECTIVE: The aim of the study was to evaluate if associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) could increase resection rates (RRs) compared with two-stage hepatectomy (TSH) in a randomized controlled trial (RCT). BACKGROUND: Radical liver metastasis resection offers the only chance of a cure for patients with metastatic colorectal cancer. Patients with colorectal liver metastasis (CRLM) and an insufficient future liver remnant (FLR) volume are traditionally treated with chemotherapy with portal vein embolization or ligation followed by hepatectomy (TSH)...
September 11, 2017: Annals of Surgery
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
#3
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...
August 31, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28859921/greater-hypertrophy-can-be-achieved-with-associating-liver-partition-with-portal-vein-ligation-for-staged-hepatectomy-compared-to-conventional-staged-hepatectomy-but-with-a-higher-price-to-pay
#4
Daryl K A Chia, Zachery Yeo, Stanley E K Loh, Shridhar Ganpathi Iyer, Glenn Kunnath Bonney, Krishnakumar Madhavan, Alfred W C Kow
BACKGROUND: Associating liver partition with portal vein ligation for staged hepatectomy (ALPPS) and conventional staged hepatectomy (CSH) are options for patients with unresectable liver tumors due to insufficient future liver remnant (FLR). METHODS: A retrospective comparison of clinical data, liver volumetry and surgical outcomes between 10 ALPPS and 29 CSH patients was performed. RESULTS: Patient demographics and disease characteristics were similar between both groups...
August 26, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28857819/partial-tipe-alpps-for-perihilar-cancer
#5
Yoshihiro Sakamoto, Masaru Matsumura, Suguru Yamashita, Naoki Ohkura, Kiyoshi Hasegawa, Norihiro Kokudo
No abstract text is available yet for this article.
August 29, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28844397/functional-considerations-in-alpps-consequences-for-clinical-management
#6
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 that underwent ALLPS was 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...
August 22, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28841539/salvage-transhepatic-arterial-embolization-after-failed-stage-i-alpps-in-a-patient-with-a-huge-hcc-with-chronic-liver-disease-a-case-report
#7
Zheng Wang, Yuanfei Peng, Qiman Sun, Xudong Qu, Min Tang, Yajie Dai, Zhaoyou Tang, Wan Yee Lau, Jia Fan, Jian Zhou
INTRODUCTION: The degree of hypertrophy of the future liver remnant (FLR) induced by associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) in patients with HCC and chronic liver disease is often limited as compared with patients with a healthy liver. PRESENTATION OF CASE: We reported a 53-year-old male who had a huge HCC (14.8×12×9.4cm) arising from a background of hepatitis B liver fibrosis (METAVIR score F3). The ratio of the FLR/standard liver volume (SLV) was 23...
July 22, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28829432/rat-model-of-the-associating-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy-alpps-procedure
#8
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/28809736/monosegmental-alpps-after-bilateral-hepatectomy
#9
Klaus Steinbrück, Marcelo D'Oliveira, Renato Cano, Marcelo Enne
Associated liver partition and portal vein ligation for staged hepatectomy (ALPPS) has emerged as an alternative for patients with bilobar colorectal liver metastasis and a small future liver remnant (FLR). In cases of extensive disease, ALPPS can be performed, leaving only one segment of the liver as FLR. We describe a case of monosegmental ALPPS using segment 4 as FLR. In conclusion, ALPPS should be reserved for a selected group of patients. Monosegmental ALPPS is feasible, but should be performed by hepatobiliary surgeons in specialized centers...
September 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/28806301/risk-adjustment-in-alpps-is-associated-with-a-dramatic-decrease-in-early-mortality-and-morbidity
#10
Michael Linecker, Bergthor Björnsson, Gregor A Stavrou, Karl J Oldhafer, Georg Lurje, Ulf Neumann, René Adam, Francois-René Pruvot, Stefan A Topp, Jun Li, Ivan Capobianco, Silvio Nadalin, Marcel Autran Machado, Sergey Voskanyan, Deniz Balci, Roberto Hernandez-Alejandro, Fernando A Alvarez, Eduardo De Santibañes, Ricardo Robles-Campos, Massimo Malagó, Michelle L de Oliveira, Mickael Lesurtel, Pierre-Alain Clavien, Henrik Petrowsky
OBJECTIVE: To longitudinally assess whether risk adjustment in Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy (ALPPS) occurred over time and is associated with postoperative outcome. BACKGROUND: ALPPS is a novel 2-stage hepatectomy enabling resection of extensive hepatic tumors. ALPPS has been criticized for its high mortality, which is reported beyond accepted standards in liver surgery. Therefore, adjustments in patient selection and technique have been performed but have not yet been studied over time in relation to outcome...
August 11, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28798996/operative-results-and-oncologic-outcomes-of-associating-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy-alpps-versus-two-stage-hepatectomy-tsh-in-patients-with-unresectable-colorectal-liver-metastases-a-systematic-review-and-meta-analysis
#11
REVIEW
Dimitrios Moris, Sean Ronnekleiv-Kelly, Ioannis D Kostakis, Diamantis I Tsilimigras, Eliza W Beal, Alexandros Papalampros, Dimitrios Dimitroulis, Evangelos Felekouras, Timothy M Pawlik
BACKGROUND: Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has recently emerged as a treatment choice for patients with colorectal liver metastases (CLM) and inadequate future liver remnant (FLR). The aim of this study was to define the results of ALPPS compared with two-stage hepatectomy (TSH) for patients with CLM. MATERIALS AND METHODS: A meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analysis guidelines...
August 10, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28795384/contribution-of-hepatobiliary-scintigraphy-in-assessing-alpps-most-suited-timing
#12
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]...
August 9, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28774330/the-paradigm-of-tumor-shrinkage-and-rapid-liver-remnant-hypertrophy-for-conversion-of-initially-unresectable-colorectal-liver-metastasis-a-case-report-and-literature-review
#13
Nan Xiao, Kailin Yu, Shaojun Yu, Jianjun Wu, Jian Wang, Siyang Shan, Shuchun Zheng, Liuhong Wang, Jianwei Wang, Shuyou Peng
BACKGROUND: For colorectal liver metastasis (CRLM) patients, hepatic resection is currently the sole cure offering the chance of long-term survival. Tumor shrinkage and planned liver remnant hypertrophy are the two key strategies for conversion of initially unresectable CRLM. First conducted in 2012, associated liver partition and portal vein ligation for staged hepatectomy (ALPPS) allows rapid liver growth. As a means to induce hypertrophy, portal vein embolization (PVE) has been widely applied before extending hepatectomy...
August 3, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28766271/rapid-liver-hypertrophy-after-portal-vein-occlusion-correlates-with-the-degree-of-collateralization-between-lobes-a-study-in-pigs
#14
Rebecca Deal, Charles Frederiks, Lauren Williams, Pim B Olthof, Konstantin Dirscherl, Xavier Keutgen, Edie Chan, Daniel Deziel, Martin Hertl, Erik Schadde
BACKGROUND: Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) induces more rapid liver growth than portal vein ligation (PVL). Transection of parenchyma in ALPPS may prevent the formation of collaterals between lobes. The aim of this study was to determine if abrogating the formation of collaterals through parenchymal transection impacted growth rate. METHODS: Twelve Yorkshire Landrace pigs were randomized to undergo ALPPS, PVL, or "partial ALPPS" by varying degrees of parenchymal transection...
August 1, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28736649/neoadjuvant-transarterial-radiation-lobectomy-for-colorectal-hepatic-metastases-a-small-cohort-analysis-on-safety-efficacy-and-radiopathologic-correlation
#15
Jehan L Shah, Ivan R Zendejas-Ruiz, Linday M Thornton, Brian S Geller, Joseph R Grajo, Amy Collinsworth, Thomas J George, Beau Toskich
Colorectal cancer patients have a high incidence of liver metastasis (ml-CRC). Surgical resection is the gold standard for treatment of hepatic metastasis but only a small percent of patients are traditional candidates based on disease extent and adequate size of the future liver remnant (FLR). Interventions such as portal vein embolization (PVE) and associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) are performed to increase FLR for operative conversion. Limitations to PVE include intrahepatic disease progression, portal vascular invasion, and utilization with concurrent chemotherapy...
June 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28732555/hepatobiliary-scintigraphy-to-evaluate-liver-function-in-associating-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy-liver-volume-overestimates-liver-function
#16
Pim B Olthof, Federico Tomassini, Pablo E Huespe, Stephanie Truant, François-René Pruvot, Roberto I Troisi, Carlos Castro, Erik Schadde, Rimma Axelsson, Ernesto Sparrelid, Roelof J Bennink, Rene Adam, Thomas M van Gulik, Eduardo de Santibanes
BACKGROUND: Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) induces a rapid and extensive increase in liver volume. The functional quality of this hypertrophic response has been called into question because ALPPS is associated with a substantial incidence of liver failure and high perioperative mortality. This multicenter study aimed to evaluate functional liver regeneration in contrast to volumetric liver regeneration in ALPPS, using technetium-99m hepatobiliary scintigraphy and computed tomography volumetry, respectively...
July 18, 2017: Surgery
https://www.readbyqxmd.com/read/28694654/evolution-of-associating-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy-simpler-safer-and-equally-effective-methods
#17
EDITORIAL
Shu-You Peng, Xu-An Wang, Cong-Yun Huang, You-Yong Zhang, Jiang-Tao Li, De-Fei Hong, Xiu-Jun Cai
Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has been recently demonstrated as a method to induce rapid and extensive hypertrophy within a short time and has been employed for a variety of primary and metastatic liver tumors. However, controversies remain due to its high morbidity and mortality. To enable safer surgery, liver surgeons have searched for better technical modifications, such as partial ALPPS, mini-ALPPS, minimally invasive ALPPS, and Terminal branches portal vein Embolization Liver Partition for Planned hepatectomy (TELPP)...
June 21, 2017: World Journal of Gastroenterology: WJG
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
#18
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/28676606/-iii-alpps-up-to-date
#19
Nozomu Sakai, Hiroaki Shimizu, Masayuki Ohtsuka, Hideyuki Yoshitomi, Katsunori Furukawa, Tsukasa Takayashiki, Shigetsugu Takano, Satoshi Kuboki, Daisuke Suzuki, Shingo Kagawa, Hiroyuki Nojima, Masaru Miyazaki
No abstract text is available yet for this article.
October 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28675369/good-to-know-the-alpps-procedure-embracing-a-new-technique
#20
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
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