Combined associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) followed by left trisectionectomy and Whipple operation for PNET

Ji, Ren; Zuo, Shi; Qiu, Siyuan; Li, Ping; Chan, Albert; Sharr, WW; Lo, Chung Mau

doi:10.21037/gs.2017.11.15

Cited by 3 publications

(4 citation statements)

References 22 publications

(22 reference statements)

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“…15 Ji et al has reported a case of a patient with a pancreatic NEN and multiple liver metastases in whom ALPPS followed by left trisectionectomy and Whipple procedure has been performed. 30 In the present study, which to the best of our knowledge is the first report on ALPPS in a case series of patients with unresectable NE LM, the 1-and 2-year DFS and OS were 73.2%, and 41.8% and 95.2% and 95.2%, respectively. The median DFS was 17.7 months.…”

Section: Discussionsupporting

confidence: 46%

ALPPS in neuroendocrine liver metastases not amenable for conventional resection – lessons learned from an interim analysis of the International ALPPS Registry

Linecker¹,

Kambakamba²,

Raptis

et al. 2020

HPB

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Background: Surgery is the most effective treatment option for neuroendocrine liver metastases (NELM). This study investigated the role of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) as a novel strategy in treatment of NELM.Methods: The International ALPPS Registry was reviewed to study patients who underwent ALPPS for NELM.Results: From 2010 to 2017, 954 ALPPS procedures from 135 international centers were recorded in the International ALPPS Registry. Of them, 24 (2.5%) were performed for NELM. Twenty-one patients entered the final analysis. Overall grade 3b morbidity was 9% after stage 1 and 27% after stage 2. Ninety-day mortality was 5%. R0 resection was achieved in 19 cases (90%) at stage 2. Median follow-up was 28 (19-48) months. Median disease free survival (DFS) was 17.3 (95% CI: 7.1-27.4) months, 1-year and 2-year DFS was 73.2% and 41.8%, respectively. Median overall survival (OS) was not reached. Oneyear and 2-year OS was 95.2% and 95.2%, respectively.Conclusions: ALPPS appears to be a suitable strategy for inclusion in the multimodal armamentarium of well-selected patients with neuroendocrine liver metastases. In light of the morbidity in this initial series and a high rate of disease-recurrence, the procedure should be taken with caution.

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Section: Discussionsupporting

confidence: 46%

ALPPS in neuroendocrine liver metastases not amenable for conventional resection – lessons learned from an interim analysis of the International ALPPS Registry

Linecker¹,

Kambakamba²,

Raptis

et al. 2020

HPB

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“…Forty-one patients with NET requiring the ALPPS approach have been published so far (http://fp.amegroups. cn/cms/ef5b8bf3a11b76b474fa9762e46828a7/hbsn-20-355-3.docx) (22,27,28,(32)(33)(34)(35)(36)(37)(38)(39). In all the patients but one, the treatment was done for hepatic NET metastases.…”

Section: Alpps Cases In Net Patientsmentioning

confidence: 99%

Uncommon indications for associating liver partition and portal vein ligation for staged hepatectomy: a systematic review

Lai¹,

Mennini²,

Laureiro³

et al. 2021

Hepatobiliary Surg Nutr

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Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) represents an innovative surgical technique used for the treatment of large hepatic lesions at high risk for post-resection liver failure due to a small future liver remnant. The most significant amount of literature concerns the use of ALPPS for the treatment of hepatocellular carcinoma (HCC), cholangiocarcinoma (CCC), and colorectal liver metastases (CRLM). On the opposite, few is known about the role of ALPPS for the treatment of uncommon liver pathologies. The objective of the present study was to evaluate the current literature on this topic. A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eligible articles published up to February 2020 were included using the MEDLINE, Scopus, and Cochrane databases. Among the 486 articles screened, 45 papers met the inclusion criteria, with 136 described cases of ALPPS for rare indications. These 136 cases were reported in 18 different countries. Only in two countries, namely Germany and Brazil, more than ten cases were observed. As for the ALPPS indications, we reported 41 (30.1%) cases of neuroendocrine tumor (NET) metastases, followed by 27 (19.9%) cases of gallbladder cancer (GBC), nine (6.6%) pediatric cases, six (4.4%) gastrointestinal stromal tumors, six (4.4%) adult cases of benign primary liver disease, four (2.9%) adult cases of malignant primary liver disease, and 43 (31.6%) adult cases of malignant secondary liver disease.According to the International ALPPS Registry data, less than 10% of the ALPPS procedures have been performed for the treatment of uncommon liver pathologies. NET and GBC are the unique pathologies with acceptable numerosity. ALPPS for NET appears to be a safe procedure, with satisfactory long-term results. On the opposite, the results observed for the treatment of GBC are poor. However, these data should be considered with caution. The rationale for treating benign pathologies with ALPPS appears to be weak.No definitive response should be given for all the other pathologies. Multicenter studies are needed with the intent to clarify the potentially beneficial effect of ALPPS for their treatment.

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“…Клас сический вариант ALPPS заключается в перевязке правой ветви воротной вены с рассечением паренхимы и последующим выполнением правосторонней или расширенной правосторонней гемигепатэктомии [12][13][14]. В то же время при обширном поражении левой доли возможно выпол нение перевязки левой воротной ветви с пересечением паренхимы и выполнением расширенной левосторонней гемигепатэктомиитак называемый "обратный" ALPPS [15]. Приводим клиническое наблюдение.…”

Section: вве де ниеunclassified

“…В мире выполнено более 1000 ALPPS, из них лишь 14% -при ГЦК [23,24]. В литературе описано 6 наблюдений обратного ALPPS, большая часть из которых выполнена при метастазах колоректального рака (таблица) [15,[24][25][26][27]. Описано 1 наблюдение, в котором эта операция была выполнена лапароскопически [28].…”

Section: вве де ниеunclassified

“Reversal” ALPPS in patient with hepatocellular carcinoma and liver cirrhosis. First clinical case in Russia

et al. 2021

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Liver resection in patients with HCC is the treatment of choice. In patients with insufficient future liver remnant (FLR) and compensated liver function performing the Associated Liver Partition and Portal vein ligation for Staged hepatectomy (ALPPS) is possible. The classic version of ALPPS consists in ligation of the right branch of the portal vein with transection of the parenchyma and then performing right hepatectomy or right trisegmentectomy. This paper describes the first case in Russia of performing ligation of the left portal branch with transection of the parenchyma and then performing left trisegmentectomy (“reversal” ALPPS) in a patient with HCC and cirrhosis. Reversal ALPPS can be successfully performed in patients with insufficient future liver remnant in well-selected patients.

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Combined associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) followed by left trisectionectomy and Whipple operation for PNET

Cited by 3 publications

References 22 publications

ALPPS in neuroendocrine liver metastases not amenable for conventional resection – lessons learned from an interim analysis of the International ALPPS Registry

ALPPS in neuroendocrine liver metastases not amenable for conventional resection – lessons learned from an interim analysis of the International ALPPS Registry

Uncommon indications for associating liver partition and portal vein ligation for staged hepatectomy: a systematic review

“Reversal” ALPPS in patient with hepatocellular carcinoma and liver cirrhosis. First clinical case in Russia

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