Alpps: Past, Present and Future

Torres, Orlando Jorge Martins; Fernandes, Eduardo S M; Herman, Paulo

doi:10.1590/s0102-67202015000300001

Cited by 9 publications

(8 citation statements)

References 9 publications

(10 reference statements)

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“…The strict selection of patients enables some groups to perform ALPPS with low mortality [6] . According to Schadde et al, among 15 patients with HCC who underwent ALPPS, incomplete resection was not observed, disease-free survival at one year was 87%, Clavien-Dindo complications ≥IIIb were 25% (colorectal liver metastasis 21%, p > 0.05), and 90-day mortality was 12% [5] . During the transection, the anterior approach can result in minor intraoperative blood loss and the need for perioperative blood transfusions.…”

Section: Discussionmentioning

confidence: 99%

“…The main indications for ALPPS are extensive bilobar colorectal liver metastases with a future liver remnant <25% [3] , [4] . According to the first international consensus meeting on ALPPS, the procedure is indicated in selected patients with HCC [5] . We present the case of a patient with HCC larger than 10 centimeters who underwent an ALPPS procedure.…”

Section: Introductionmentioning

confidence: 99%

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The ALPPS procedure for hepatocellular carcinoma larger than 10 centimeters

Torres

Vasques

Silva

et al. 2016

International Journal of Surgery Case Reports

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The ALPPS procedure for hepatocellular carcinoma larger than 10 centimeters

Torres

Vasques

Silva

et al. 2016

International Journal of Surgery Case Reports

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“…On the contrary, ALPPS has been reported in HCC patients, particularly when there is vascular invasion. Torres et al[63] reported zero incomplete resection in HCC patients; a 1-year DFS of 87%, 90-d mortality of 12% and rate of high-grade complications (Clavien-Dindo complications IIIb or more) of 25%. Björnsson et al[64] reported no 90-d mortality in patients who underwent ALPPS for primary hepatobiliary malignancies (4 out of 10 patients had HCC).…”

Section: Discussionmentioning

confidence: 99%

Outcomes of staged hepatectomies for liver malignancy

Albati

Korairi

Hasan

et al. 2019

WJH

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Liver malignancies are the fifth most common cause of death worldwide. Surgical intervention with curative intent is the treatment of choice for liver tumors as it provides long-term survival. However, only 20% of patients with metastatic liver lesions can be managed by curative liver resection. In most of the cases, hepatectomy is not feasible because of insufficient future liver remnant (FLR). Two-stage hepatectomy is advocated to achieve liver resection in a patient who is considered to not be a candidate for resection. Procedures of staged hepatectomy include conventional two-stage hepatectomy, portal vein embolization, and associating liver partition and portal vein ligation for a staged hepatectomy. Technical success is high for each of these procedures but variable between them. All the procedures have been reported as being effective in achieving a satisfactory FLR and completing the second-stage resection. Moreover, the overall survival and disease-free survival rates have improved significantly for patients who were otherwise considered nonresectable; yet, an increase in the morbidity and mortality rates has been observed. We suggest that this type of procedure should be carried out in high-flow centers and through a multidisciplinary approach. An experienced surgeon is key to the success of those interventions.

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“…While ALPPS has been shown to induce fast hypertrophy of the FLR, it still raises passionate discussion at HPB community regarding indications, morbidity and oncological outcomes. [19][20][21][22][23][24] Salvage ALPPS may be the least questionable indication for this procedure and is a potential rescue strategy when PVO fails to induce the necessary hypertrophy of the FLR.…”

Section: Discussionmentioning

confidence: 99%