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https://www.readbyqxmd.com/read/28809736/monosegmental-alpps-after-bilateral-hepatectomy
#1
Klaus Steinbru Ck, 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...
August 8, 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/28807245/portal-vein-ligation-versus-portal-vein-embolization-for-induction-of-hypertrophy-of-the-future-liver-remnant-a-systematic-review-and-meta-analysis
#2
REVIEW
C J Isfordink, M Samim, M N G J A Braat, A M Almalki, J Hagendoorn, I H M Borel Rinkes, I Q Molenaar
An important risk of major hepatic resection is postoperative liver failure, which is directly related to insufficient future liver remnant (FLR). Portal vein embolization (PVE) and portal vein ligation (PVL) can minimize this risk by inducing hypertrophy of the FLR. The aim of this systematic review and meta-analysis was to compare the efficacy and safety of PVE and PVL for FLR hypertrophy. A systematic search was conducted on the17(th) of January 2017. The methodological quality of the studies was assessed using the Oxford Critical Appraisal Skills Program for cohort studies...
September 2017: Surgical Oncology
https://www.readbyqxmd.com/read/28806301/risk-adjustment-in-alpps-is-associated-with-a-dramatic-decrease-in-early-mortality-and-morbidity
#3
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
#4
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
#5
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
#6
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/28767916/transection-of-the-hepatic-parenchyma-associated-or-not-with-the-contralateral-portal-vein-branch-ligature-and-its-effect-in-liver-regeneration
#7
Henrique de Aguiar Wiederkehr, Julio Cesar Wiederkehr, Luiz Martins Collaço, Eros Luiz de Sousa, Paolo Salvalaggio, Caroline Aragão de Carvalho, Barbara de Aguiar Wiederkehr, Camila Aparecida Moraes Marques, Francielle França da Rosa, Felipe de Negreiros Nanni, Taíse Fuchs
Objective: To analyze the influence of portal vein ligation in hepatic regeneration by immunohistochemical criteria. Methods: Ten pigs divided into two groups of five animals underwent hepatectomy in two stages, and the groups were differentiated by ligation or not of the left portal vein tributary, which is responsible for vascularization of the left lateral and medial lobes of the pig liver. Five days after the procedure, the animals underwent liver biopsies for further analysis of histological and immunohistochemical with marker Ki67...
April 2017: Einstein
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
#8
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/28740341/glutamine-prevents-oxidative-stress-in-a-model-of-portal-hypertension
#9
Gilmara Pandolfo Zabot, Gustavo Franco Carvalhal, Norma Possa Marroni, Francielli Licks, Renata Minuzzo Hartmann, Vinícius Duval da Silva, Henrique Sarubbi Fillmann
AIM: To evaluate the protective effects of glutamine in a model of portal hypertension (PH) induced by partial portal vein ligation (PPVL). METHODS: Male Wistar rats were housed in a controlled environment and were allowed access to food and water ad libitum. Twenty-four male Wistar rats were divided into four experimental groups: (1) control group (SO) - rats underwent exploratory laparotomy; (2) control + glutamine group (SO + G) - rats were subjected to laparotomy and were treated intraperitoneally with glutamine; (3) portal hypertension group (PPVL) - rats were subjected to PPVL; and (4) PPVL + glutamine group (PPVL + G) - rats were treated intraperitoneally with glutamine for seven days...
July 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28736649/neoadjuvant-transarterial-radiation-lobectomy-for-colorectal-hepatic-metastases-a-small-cohort-analysis-on-safety-efficacy-and-radiopathologic-correlation
#10
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/28735514/laparoscopic-associating-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy
#11
Konstantinos Perivoliotis, Eleni Sioka, Ioannis Mamaloudis, Dimitrios Zacharoulis
No abstract text is available yet for this article.
October 2017: Minerva Chirurgica
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
#12
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/28706885/omega-3-fatty-acids-inhibit-oxidative-stress-in-a-rat-model-of-liver-regeneration
#13
Ozgur Firat, Ozer Makay, Levent Yeniay, Goksel Gokce, Cigdem Yenisey, Ahmet Coker
PURPOSE: Lipid peroxidation and consequent reactive oxygen species in the setting of oxidative stress have crucial roles in liver regeneration, which may adversely affect the regeneration itself and lead to liver failure. The aim of the current study is to investigate whether omega-3 fatty acid supplementation inhibits oxidative stress in an experimental model of liver regeneration. METHODS: Forty rats were allocated to four groups. Rats in group A received a sham operation...
July 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28694654/evolution-of-associating-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy-simpler-safer-and-equally-effective-methods
#14
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
#15
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
#16
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/28672979/applying-negative-pressure-wound-therapy-in-associating-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy-a-case-report
#17
Bo Zhai, Xin Jin, Rui Wang, Taishi Fang, Jing Qu, Ying Wang, Ming Liu, Lishan Xu
Staged hepatectomy, particularly associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is a recently developed advanced surgery for resecting liver tumors. However, large wound surfaces, incomplete drainage and high rates of mortality are vital limitations of ALPPS. The present case study describes a patient with liver cancer who underwent ALPPS surgery combined with negative pressure wound therapy. A 46-year-old male patient was hospitalized due to right upper abdominal pain. Computed tomography and magnetic resonance cholangiopancreatography scan results indicated gallbladder cancer, accompanied by multiple liver metastases...
July 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28652892/abdominal-cross-sectional-imaging-of-the-associating-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy-procedure
#18
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/28651622/modulation-of-hepatic-perfusion-did-not-improve-recovery-from-hepatic-outflow-obstruction
#19
J Arlt, W Wei, C Xie, A Homeyer, U Settmacher, U Dahmen, O Dirsch
BACKGROUND: Focal hepatic venous outflow obstruction frequently occurs after extended liver resection and leads to a portal hypertension, arterial hypoperfusion and parenchymal necrosis. In this study, we investigated the pharmacological modulation of liver perfusion and hepatic damage in a surgical model of hepatic outflow obstruction after extended liver resection by administration of 5 different drugs in comparison to an operative intervention, splenectomy. METHODS: Male inbred Lewis rats (Lew/Crl) were subjected to right median hepatic vein ligation + 70% partial hepatectomy...
June 26, 2017: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28640476/histogram-analyses-of-diffusion-kurtosis-indices-and-apparent-diffusion-coefficient-in-assessing-liver-regeneration-after-alpps-and-a-comparative-study-with-portal-vein-ligation
#20
Ruo-Fan Sheng, He-Qing Wang, Kai-Pu Jin, Li Yang, Hao Liu, Yuan Ji, Cai-Xia Fu, Meng-Su Zeng
PURPOSE: To investigate the value of diffusion kurtosis imaging (DKI) histogram analysis in assessing liver regeneration and the microstructure basis after associating liver partition and portal vein ligation for staged hepatectomy (ALPPS), in comparison with portal vein ligation (PVL). MATERIALS AND METHODS: Thirty rats were divided into the ALPPS, PVL, and control groups. Histograms of DKI using a 3T magnetic resonance imaging (MRI) scanner were performed for corrected apparent diffusion (D), kurtosis (K), and apparent diffusion coefficient (ADC)...
June 22, 2017: Journal of Magnetic Resonance Imaging: JMRI
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