Clinical evaluation of modified ALPPS procedures based on risk-reduced strategy for staged hepatectomy

• Main Authors: Jie Li, Guang-Sheng Yang, Ke-Jian Sun, Yan Ma, Xiao-Wang Bi, Xu Han
• Format: Article
• Language: English
• Published: Elsevier 2021-01-01
• Series: Annals of Hepatology
• Subjects: ALPPS; Liver; Risk; Complication; Overall survival
• Online Access: http://www.sciencedirect.com/science/article/pii/S1665268120301605

Introduction and Objectives: Radical resection remains the only curative treatment for liver tumors. Although associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) can increase the resection rate, huge controversy exists for high reported mortality and morbidity. This study was to evaluate the efficacy and safety of modified ALPPS procedure. Patients and Methods: Patients who were performed ALPPS in single-center in recent 5 years were retrospectively reviewed. The modified strategy included strict patient selection, precise future liver remnant (FLR) assessment and operation planning, and usage of minimally invasive methods. Data including clinical records, functional FLR increase, complications, and overall survival (OS) were analyzed. Results: Sixty patients underwent modified ALPPS procedure and recovered well. No severe complications happened after the 1-stage operation, and the increasing FLR was 179.3 cm3(±72.4 cm3), with similar functional FLR increase. The OS was 20.0 months (±4.5month). Conclusions: ALPPS could be a feasible treatment for complex liver tumors by risk-reduced modification. It could be expected to provide long-term survival for patients without enough FLR.