Skip to main content
Top
Published in: Journal of Gastrointestinal Surgery 1/2013

01-01-2013 | Case Report

Using ALPPS to Induce Rapid Liver Hypertrophy in a Patient with Hepatic Fibrosis and Portal Vein Thrombosis

Authors: Keith M. Cavaness, M. B. Majella Doyle, Yiing Lin, Erin Maynard, William C. Chapman

Published in: Journal of Gastrointestinal Surgery | Issue 1/2013

Login to get access

Excerpt

Large or critically located hepatic tumors continue to be a challenge for surgeons as they push to obtain adequate surgical margins and often leave less residual liver behind. While it has been shown that up to 80 % of a healthy liver can be resected, additional challenges exist with the “less than healthy liver” when planning an operative procedure and determining the future liver remnant (FLR) volume. The main goal is to obtain adequate margins while avoiding postoperative liver decompensation and failure. Postoperative liver failure (PLF) has been reported to have a mortality rate as high as 32 % and is often associated with sepsis and multisystem organ failure.1
Literature
1.
go back to reference de Santibañes E, Alvarez FA, Ardiles V. How to avoid postoperative liver failure: a novel method. World J Surg 2012;36:125–8.PubMedCrossRef de Santibañes E, Alvarez FA, Ardiles V. How to avoid postoperative liver failure: a novel method. World J Surg 2012;36:125–8.PubMedCrossRef
2.
go back to reference Clavien PA, Petrowsky H, DeOliveira ML, Graf R. Strategies for safer liver surgery and partial liver transplantation. N Engl J Med 2007;356:1545–59.PubMedCrossRef Clavien PA, Petrowsky H, DeOliveira ML, Graf R. Strategies for safer liver surgery and partial liver transplantation. N Engl J Med 2007;356:1545–59.PubMedCrossRef
3.
go back to reference Earl TM, Chapman WC. Conventional Surgical Treatment of Hepatocellular Carcinoma. Clin Liver Dis 2011;15:353–70, vii-x. Earl TM, Chapman WC. Conventional Surgical Treatment of Hepatocellular Carcinoma. Clin Liver Dis 2011;15:353–70, vii-x.
4.
go back to reference Hemming AW, Reed AI, Howard RJ, et al. Preoperative portal vein embolization for extended hepatectomy. Ann Surg 2003;237:686–91; discussion 691–3PubMed Hemming AW, Reed AI, Howard RJ, et al. Preoperative portal vein embolization for extended hepatectomy. Ann Surg 2003;237:686–91; discussion 691–3PubMed
5.
go back to reference Makuuchi M, Thai BL, Takayasu K, et al. Preoperative portal embolization to increase safety of major hepatectomy for hilar bile duct carcinoma: a preliminary report. Surgery 1990;107:521–7.PubMed Makuuchi M, Thai BL, Takayasu K, et al. Preoperative portal embolization to increase safety of major hepatectomy for hilar bile duct carcinoma: a preliminary report. Surgery 1990;107:521–7.PubMed
6.
go back to reference Adam R, Laurent A, Azoulay D, et al. Two-stage hepatectomy: A planned strategy to treat irresectable liver tumors. Ann Surg 2000;232:777–85.PubMedCrossRef Adam R, Laurent A, Azoulay D, et al. Two-stage hepatectomy: A planned strategy to treat irresectable liver tumors. Ann Surg 2000;232:777–85.PubMedCrossRef
7.
go back to reference Aussilhou B, Lesurtel M, Sauvanet A, et al. Right portal vein ligation is as efficient as portal vein embolization to induce hypertrophy of the left liver remnant. J Gastrointest Surg 2008;12:297–303.PubMedCrossRef Aussilhou B, Lesurtel M, Sauvanet A, et al. Right portal vein ligation is as efficient as portal vein embolization to induce hypertrophy of the left liver remnant. J Gastrointest Surg 2008;12:297–303.PubMedCrossRef
8.
go back to reference Schnitzbauer AA, Lang SA, Goessmann H, et al. 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;255:405–14.PubMedCrossRef Schnitzbauer AA, Lang SA, Goessmann H, et al. 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;255:405–14.PubMedCrossRef
9.
go back to reference de Santibañes E, Clavien PA. Playing Play-Doh to prevent postoperative liver failure: the "ALPPS" approach. Ann Surg 2012;255:415–7.PubMedCrossRef de Santibañes E, Clavien PA. Playing Play-Doh to prevent postoperative liver failure: the "ALPPS" approach. Ann Surg 2012;255:415–7.PubMedCrossRef
Metadata
Title
Using ALPPS to Induce Rapid Liver Hypertrophy in a Patient with Hepatic Fibrosis and Portal Vein Thrombosis
Authors
Keith M. Cavaness
M. B. Majella Doyle
Yiing Lin
Erin Maynard
William C. Chapman
Publication date
01-01-2013
Publisher
Springer-Verlag
Published in
Journal of Gastrointestinal Surgery / Issue 1/2013
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-012-2029-9

Other articles of this Issue 1/2013

Journal of Gastrointestinal Surgery 1/2013 Go to the issue

2012 SSAT Presidential Address

Relationships Matter