Radio-frequency-assisted Liver Partition With Portal Vein Ligation (RALPP) for Liver Regeneration

Gall, Tamara; Sodergren, Mikael H.; Frampton, Adam E.; Fan, Ruifang; Spalding, Duncan; Habib, Nagy; Pai, Madhava; Jackson, James E.; Tait, Paul; Jiao, Long R.

doi:10.1097/sla.0000000000000607

Cited by 94 publications

(60 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The summaries of these reports are listed in Table 3 [18, 50, 55, 70, 71]. The presented results are similar to the known characteristics of ALPPS; a rapid and merked hypertrophy and high mortality.…”

Section: A Comparison Of Pve and Alppssupporting

confidence: 72%

“…In fact, various refinements to the ALPPS procedure are being reported to improve on the morbidity and mortality rates. These changes include using different approaches of in situ liver splitting (tourniquet compression [17] and radiofrequency ablation [18]), differing extent of liver transection (partial ALPPS [19]), and selecting different planes of liver splitting (right and left ALLPS [20], monosegment ALPPS [21]).…”

Section: General Remarks On Pve and Alppsmentioning

confidence: 99%

See 1 more Smart Citation

Portal Vein Embolization versus Associated Liver Partition and Portal Vein Ligation for Staged Hepatectomy

Hashimoto¹,

Makuuchi²

2018

Dig Surg

View full text Add to dashboard Cite

Background/Aims: Liver failure after extended hepatic resection is an obstacle that must be overcome by hepatobiliary surgeons. Portal vein embolization (PVE) played an important role in dealing with this issue since the last 30 years. Recently, a new strategy known as “Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS)” has been developed. To clarify the advantage and disadvantage of ALPPS, we reviewed the published articles. Methods: A web search was performed in “PubMED” databases to identify the articles published that were related to this topic. Based on the results, a comparative investigation was carried out. Results: The reported advantages of ALPPS are: rapid liver hypertrophy and a remarkably high resectability rate. The hypertrophy rate in PVE and ALPPS is 10–80 and 47–160%. The disadvantages of ALPPS compared to PVE are high morbidity and mortality rates. The morbidity rates for PVE and ALLPS are 8–49 and 12–100%, respectively, and the mortality rates for PVE and ALPPS are 0–8.8 and 0–28.7%, respectively. Due to the short history of ALPPS, details of the mechanism underlying ALPPS have not yet been fully clarified and a suitable indication for the practice of ALPPS is currently under debate. Conclusion: It is imperative that the issue of a high mortality rate following ALPPS is immediately resolved before ALPPS can be widely accepted. In addition, comparison studies between PVE and ALPPS must be conducted to elicit proper and appropriate applications of PVE and ALPPS.

show abstract

Section: A Comparison Of Pve and Alppssupporting

confidence: 72%

Section: General Remarks On Pve and Alppsmentioning

confidence: 99%

Portal Vein Embolization versus Associated Liver Partition and Portal Vein Ligation for Staged Hepatectomy

Hashimoto¹,

Makuuchi²

2018

Dig Surg

View full text Add to dashboard Cite

show abstract

“…Laparoscopic surgery has well known benefits for the patient, in particular, quicker recovery, less analgesic requirements, shorter length of stay and reduced morbidity. This laparoscopic technique has been shown to be safe and feasible in patients requiring staged hepatectomy (3).…”

Section: Discussionmentioning

confidence: 99%

A totally laparoscopic associating liver partition and portal vein ligation for staged hepatectomy assisted with radiofrequency (radiofrequency assisted liver partition with portal vein ligation) for staged liver resection

Jiao¹,

Hakim²,

Gall³

et al. 2016

Hepatobiliary Surg. Nutr.

Self Cite

View full text Add to dashboard Cite

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. An increased liver volume of 57.9% was seen after 14 days. This technique is feasible to perform and compares favourably to other ALPPS methods whilst gaining the advantages of laparoscopic surgery.Keywords: Radiofrequency assisted liver partition with portal vein ligation (RALPP); associating liver partition and portal vein ligation for staged hepatectomy (ALPPS); liver resection; two-stage; portal vein ligation; radiofrequency ablation

show abstract

“…16 Gall et al proposed another modification of ISS named "Radio-frequency-assisted liver partition with portal vein ligation (RALPP)", they re-placed the ISS with a precise avascular area up to 1 cm by using in-line radio frequency. 17 They applied this technique in 5 patients (4 patients was performed laparo-scopically), and found that RALLP could significantly increase the FLR by a median of 62.3% within 21.8 days, while the morbidity and mortality were 20% and 0% respectively. None patients developed a postoperative bile leak and mortality at 90 days.…”

Section: The Modifications Of Alppsmentioning

confidence: 99%

ALPPS readdresses the management of advanced liver tumors

Huang

Xiao²,

Jun

et al. 2017

Int Surg J

View full text Add to dashboard Cite

Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has been developed to induce rapid liver hypertrophy of the future liver remnant (FLR) prior to hepatectomy in primarily non-resectable or marginally resectable liver tumors. In recent years, this novel strategy has aroused interests of many liver surgeons. Its indications have been broadened gradually with more and more reported cases. Modified ALPPS is also developed to reduce morbidity and mortality. The authors searched Medline and PubMed to identify related articles published in English, using terms: “ALPPS, associating liver partition and portal vein ligation for staged hepatectomy, in situ split, in situ splitting, liver partition”. The authors summarized and analysed the superiority, indications, modifications, safety, mechanisms of regeneration of ALPPS. ALPPS was more effective than traditional portal vein embolization (PVE) or portal vein ligation (PVL). ALPPS obtained 80% volume increase of future liver remnant (FLR ) within 7 days in contrast to 10%-46% within 2 to 8 weeks by PVE or PVL. ALPPS opens a chapter in the history of liver surgery and readdresses the management of advanced primary and metastatic liver tumors. The high morbidity and mortality associated with ALPPS could be decreased remarkably if we carefully select patients and carry out the operation with experienced surgeons. In addition, the safety, mechanisms and oncological outcome of ALPPS are still not clear, which need further research and randomized controlled trials.

show abstract

Radio-frequency-assisted Liver Partition With Portal Vein Ligation (RALPP) for Liver Regeneration

Cited by 94 publications

References 9 publications

Portal Vein Embolization versus Associated Liver Partition and Portal Vein Ligation for Staged Hepatectomy

Portal Vein Embolization versus Associated Liver Partition and Portal Vein Ligation for Staged Hepatectomy

A totally laparoscopic associating liver partition and portal vein ligation for staged hepatectomy assisted with radiofrequency (radiofrequency assisted liver partition with portal vein ligation) for staged liver resection

ALPPS readdresses the management of advanced liver tumors

Contact Info

Product

Resources

About