New Method of Hepatic Regeneration

Alvarez, Fernando A.; Iniesta, José; Lastiri, José; Ulla, Marina; Lassalle, Fernando Bonadeo; Santibañés, Eduardo de

doi:10.1016/j.cireng.2011.08.001

Cited by 14 publications

(9 citation statements)

References 8 publications

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“…In patient presented above, the ratio of FLR hypertrophy was 98% at 11 days, significantly higher than those reported with PVL. The higher hypertrophy ratio achieved by ALPPS procedure in the patient presented above is similar to those reported by other authors (22)(23)(24), who revealed a statistically significant increase in FLR volume after ALPPS than in patients undergoing PVE/PVL, allowing the performance of R0 resections in almost 100% of patients subjected to this new approach (25,26). Moreover, recent studies revealed that in patients who failed to achieve sufficient FLR hypertrophy after PVE, the performance of ALPPS was an effective strategy, able to induce a FLR gain which allowed subsequent R0 resection (26;27).…”

Section: Discussion Discussionsupporting

confidence: 80%

Primary Hepatic Lymphoma Resected by ALPPS Procedure (Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy)

Alexandrescu¹,

Stoica²,

Grigorie³

et al. 2016

JTMR

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Background: Primary hepatic lymphoma represents a very rare location of non-Hodgkin lymphomas, whose treatment consists of liver tumor resection followed by chemotherapy. In some cases, however, upfront hepatectomy is not feasible due to insufficient volume of the liver remnant. Case report: An ALPPS (Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy) procedure was performed in a patient with a large primary hepatic lymphoma, whose estimated liver remnant represented only 13% of total liver volume, it was performed. During the first stage, we performed right portal branch ligation and in situ splitting, without right bile duct ligation. After the first stage, the patient did not develop biliary fistula, ascites or sepsis. The volume of segments 2 and 3 increased by 98% after eleven days, making possible subsequent resection of the tumor by a right trisectionectomy. The patient did not develop any complication, being discharged 9 days after the second stage of ALPPS. Postoperatively, the patient underwent chemotherapy, being disease-free at 13 months following operation. Conclusion: This is the first patient presented in the literature who underwent ALPPS for resection of a primary hepatic lymphoma. This type of tumor could be managed by ALPPS, with low morbidity and mortality rates. Abbreviations: ALPPS -Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy, PHL -primary hepatic lymphoma, PVE -portal vein embolization, PVL -portal vein ligation, FLR -future liver remnant

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Section: Discussion Discussionsupporting

confidence: 80%

Primary Hepatic Lymphoma Resected by ALPPS Procedure (Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy)

Alexandrescu¹,

Stoica²,

Grigorie³

et al. 2016

JTMR

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“…Following this initial poster presentation, the yet unnamed procedure was taken up by an Argentinian group [21]. They reported its application to three cases that were previously considered unresectable owing to inadequate FLR volume [22].…”

Section: International Uptakementioning

confidence: 98%

ALPPS: Challenging the concept of unresectability – A systematic review

Bertens

Hawel

Lung

et al. 2015

International Journal of Surgery

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“…8 This technique is known as ALPPS (associating liver partition and portal vein ligation for staged hepatectomy). [9][10][11] The advantage ALPPS provides is the seemingly bigger and faster liver hypertrophy, compared to that obtained with portal vein occlusion only. 12 Enthusiasm from these findings has led different surgical groups, including ours, to perform this procedure lacking basic supporting evidence.…”

Section: Introductionmentioning

confidence: 94%

“…Several clinical communications have demonstrated an increase in ALPPS morbidity and mortality in comparison to conventional 2-stage hepatectomy. [9][10][11] In 2000, Great Britain's Medical Research Council (MRC) established the provisions for evaluating complex surgical procedures and the development of new procedures. MRC recommendations include: developing and accessing, through iterative phases, the use of experimental models instead of observational designs whenever possible, measuring results, reporting surgeries in detail for better reproducibility, summarising evidence and achieving wider application.…”

Section: Introductionmentioning

confidence: 99%