The Associated Liver Partition with Portal Vein Ligation for Staged Hepatectomy (ALPPS) approach for staged hepatic
resection in patients with a small functional liver remnant has captivated the attention
of hepatobiliary pancreatic (HPB) surgery since initially being reported in 2012.
1
The strategy to consolidate a complex operative therapy into a shorter, time-framed,
staged resection based on the liver's remarkable regenerative capacity appeals to
both patient and surgeon. ALPPS entry into the realm of HPB surgery has been striking,
alluring to some, affronting to others, and undoubtedly controversial. Patients, however,
only grasp that ALPPS provides a quicker solution for staged operations of their hepatic
metastases with assumedly similar outcomes. Surgeons' perceptions and responsibilities
are far broader and demand that the enthusiasm for a novel approach be tempered by
rigorous assessment and appropriately defined indications. To date, the indications
for ALPPS are still evolving, and the associated risks have been considered formidable
by many surgeons. As with any novel operative approach, technical refinement and outcomes
analysis of ALPPS are critical for the HPB community at large to judge its true value.To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Right portal vein ligation combined with in situ splitting induces rapid left lateral liver lobe hypertrophy enabling 2-staged extended right hepatic resection in small-for-size settings.Ann Surg. 2012; 255: 405-414
- Can we improve the morbidity and mortality associated with the associating liver partition with portal vein ligation for staged hepatectomy (ALPPS) procedure in the management of colorectal liver metastases?.Surgery. 2015; 157: 194-201
- Systemic chemotherapy and two-stage hepatectomy for extensive bilateral colorectal liver metastases: perioperative safety and Survival.J Gastrointest Surg. 2007; 11: 1498-1505
- ALPPS procedure: our experience and state of the art.Hepatogastroenterology. 2013; 60: 2069-2075
- ALPPS offers a better chance of complete resection in patients with primarily unresectable liver tumors compared with conventional-staged hepatectomies: results of a multicenter analysis.World J Surg. 2014; 38: 1510-1519
Article info
Publication history
Accepted:
August 19,
2014
Identification
Copyright
© 2015 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
