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Magda Langiewicz, Andrea Schlegel, Enrica Saponara, Michael Linecker, Pieter Borger, Rolf Graf, Bostjan Humar, Pierre A Clavien
BACKGROUND & AIMS: Occlusion of one liver section by portal vein ligation (PVL) induces compensatory liver regeneration in the remaining part. PVL-induced liver growth is being exploited for the surgical removal of large/multiple liver tumors. A novel approach coined ALPPS (Associating Liver Partition and Portal vein ligation for Staged hepatectomy) combines PVL with parenchymal transection and massively accelerates compensatory growth, enabling much faster and more extensive tumor removal...
October 19, 2016: Journal of Hepatology
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...
October 20, 2016: Updates in Surgery
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...
October 19, 2016: Langenbeck's Archives of Surgery
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
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...
October 12, 2016: Annals of Surgical Oncology
L X Cai, S L He, F Q Wei, Y C Yu, X J Cai
Objective: The aim was to explore the strategy and clinical value of laparoscopic transection of median hepatic fissure (MHF) in difficult laparoscopic liver resections. Methods: First the MHF was located and marked, then the transection plane of the MHF was set. Next, the laparoscopic Multifuctional Operative Dissector (LPMOD) and the technique of curettage and aspiration were utilized to transect the liver beginning from the middle portion of the gallbladder fossa, in a caudal-to-cranial and anterior-to-posterior direction, until the clear exposure of the anterior surface of the intrahepatic inferior vena cava...
September 13, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Hauke Lang
No abstract text is available yet for this article.
September 22, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
D Eshmuminov, D A Raptis, M Linecker, A Wirsching, M Lesurtel, P-A Clavien
BACKGROUND: Discussion is ongoing regarding whether associating liver partition with portal vein ligation for staged hepatectomy (ALPPS) or portal vein occlusion is better in staged hepatectomy. The aim of this study was to compare available strategies using a two-stage approach in extended hepatectomy. METHODS: A literature search was performed in MEDLINE, Scopus, the Cochrane Library and Embase, and additional articles were identified by hand searching. Data from the international ALPPS registry were extracted...
September 16, 2016: British Journal of Surgery
Daisuke Kawaguchi, Yukihiko Hiroshima, Kenichi Matsuo, Itaru Endo, Keiji Koda, Kuniya Tanaka
AIM: To evaluate whether the congested area that develops in associating liver partition with portal vein ligation for staged hepatectomy (ALPPS) contributes to rapid future liver remnant (FLR) hypertrophy. PATIENTS AND METHODS: Eight patients undergoing liver partition and right portal vein (RPV) ligation within the FLR in the first operation of ALPPS were compared with eight patients undergoing RPV embolization in the FLR as the first operation of classical two-stage (CTS) hepatectomy...
September 2016: Anticancer Research
Kuniya Tanaka, Yutaro Kikuchi, Daisuke Kawaguchi, Takashi Murakami, Yukihiko Hiroshima, Kenichi Matsuo
OBJECTIVE: We describe a modified procedure associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) including portal pedicle preservation during parenchymal division, thus avoiding necrosis. BACKGROUND: Although ALPPS recently has been advocated for treating advanced liver tumors, sepsis originating from the ischemic area produced by parenchymal division increases mortality, accounting for one-third of postoperative deaths. METHODS: Our procedure differs from the original ALPPS technique by sparing portal pedicles at the transection plane, thus maintaining blood supply...
September 8, 2016: Annals of Surgery
Giovanni Battista Levi Sandri, Giovanni Vennarecci, Giuseppe Maria Ettorre
No abstract text is available yet for this article.
September 6, 2016: Annals of Surgery
Albert C Y Chan, Kenneth Chok, Jeff W C Dai, Chung Mau Lo
BACKGROUND: Recent evidence suggested that associating liver partition and portal vein ligation for staged hepatectomy with a partial split could effectively induce the same degree of future liver remnant hypertrophy as a complete split in non-cirrhotic and non-cholestatic livers with better postoperative safety profiles. Our aim was to evaluate if the same phenomenon could be applied to hepatitis-related chronic liver diseases. METHODS: In the study, 25 patients who underwent associating liver partition and portal vein ligation for staged hepatectomy from October 2013 to January 2016 for hepatocellular carcinoma were analyzed...
September 2, 2016: Surgery
Z G Hu, P B Huang, Z Y Zhou, C C He, H Y Zhang, W B Li, Z Y Xiao, J L Zhang, Y Y Xu, K Xu, C H Fang, J Wang
OBJECTIVE: To preliminarily explore the application value of two-dimensional image technology and three-dimensional visualization technology in hepatocellular carcinoma(HCC) treated by associating liver partition and portal vein ligation for staged hepatectomy(ALPPS). METHODS: Clinical data of nineteen HCC patients treated by ALPPS were retrospectively analyzed in Sun-Yat-Sen Memorial Hospital of Sun Yat-Sen University from August 2013 to May 2015.Preoperative assessment, surgical planning and intraoperative guidance were assisted by traditional two-dimensional imaging technology(group 2D) in 15 cases, and the rest 4 cases were assisted by three-dimensional visualization technology(group 3D)...
September 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Marcello Donati, Gregor A Stavrou, Axel Stang, Francesco Basile, Karl J Oldhafer
No abstract text is available yet for this article.
September 2016: Surgical Oncology
Ram Venkatesh Anantha, Christopher Ryan Shaler, Courtney Erin Meilleur, Jeremy Parfitt, S M Mansour Haeryfar, Roberto Hernandez-Alejandro
BACKGROUND AND AIMS: A short-interval, two-stage approach termed associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) increases the number of patients with extensive malignant disease of the liver and a small future liver remnant (FLR) that can undergo liver resection. While this approach results in accelerated liver hypertrophy of the FLR, it remains unknown whether this phenomenon is restricted to liver parenchymal cells. In the current study, we evaluated whether ALPPS alters the immunological composition of the deportalized lobe (DL) and the FLR...
2016: Frontiers in Medicine
Patryk Kambakamba, Daniel Stocker, Cäcilia S Reiner, Thi Dan Nguyen-Kim, Michael Linecker, Dilmurodjon Eshmuminov, Henrik Petrowsky, Pierre-Alain Clavien, Mickael Lesurtel
BACKGROUND: Posthepatectomy liver failure (PHLF) may occur after ALPPS (Associating liver partition and portal vein ligation for staged hepatectomy) despite a sufficient standardized future liver remnant (sFLR) volume. The aim of this study was to test kinetic growth rate (KGR) after ALPPS stage 1, describing the percentage increase of sFLR per day, as a predictor of PHLF after completion of ALPPS. METHODS: The ability of KGR to predict PHLF after ALPPS stage 2 was investigated in 38 patients...
October 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
R Adam, K Imai, C Castro Benitez, M-A Allard, E Vibert, A Sa Cunha, D Cherqui, H Baba, D Castaing
BACKGROUND: Although associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has been increasingly adopted by many centres, the oncological outcome for colorectal liver metastases compared with that after two-stage hepatectomy is still unknown. METHODS: Between January 2010 and June 2014, all consecutive patients who underwent either ALPPS or two-stage hepatectomy for colorectal liver metastases in a single institution were included in the study...
October 2016: British Journal of Surgery
Long R Jiao, David N Hakim, Tamara M H Gall, Ana Fajardo, Tim D Pencavel, Ruifang Fan, Mikael H Sodergren
In order to induce liver hypertrophy to enable liver resection in patients with a small future liver remnant (FLR), various methods have been proposed in addition to portal vein embolisation (PVE). Most recently, the associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) technique has gained significant international interest. This technique is limited by the high morbidity associated with an in situ liver splitting and the patient undergoing two open operations. We present the case of a variant ALPPS technique performed entirely laparoscopically with no major morbidity or mortality...
August 2016: Hepatobiliary Surgery and Nutrition
Orlando Jorge M Torres, Rodrigo Rodrigues Vasques, Thiago Henrique S Silva, Miguel Eugenio L Castelo-Branco, Camila Cristina S Torres
INTRODUCTION: The only means of achieving long-term survival in hepatocellular carcinoma is complete tumor resection or liver transplantation. Patients with large hepatocellular carcinomas are currently not considered for liver transplantation. Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is indicated in selected patients. We present the case of a patient with a huge hepatocellular carcinoma who underwent an ALPPS procedure. PRESENTATION OF CASE: A 57-year-old man initially presented with a tumor measuring 19cm×10cm in the right lobe of the liver...
2016: International Journal of Surgery Case Reports
Stéphanie Truant, Clio Baillet, Anne Claire Deshorgue, Emmanuelle Leteurtre, Mohamed Hebbar, Olivier Ernst, François-René Pruvot
No abstract text is available yet for this article.
July 29, 2016: Annals of Surgery
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