Discussion about The Indications and Contradictions of ALPPS for Primary Hepatocellular Carcinoma Patients (Reports of 15 Cases)_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 PENGChi-han , LIChuan ,  WENTian-fu , YANLü-nan , LIBo , YANGJia-yin , WANGWen-tao , XUMing-qing

Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China;

Corresponding author：

WENTian-fu, Email: tianfu1962@163.com

Keywords：

ALPPS; Hepatocellular carcinoma; Indication; Contradiction

DOI：

10.7507/1007-9424.20150308

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To discussion the indications and contradictions of associating liver partition and potal vein ligation for staged hepatectomy (ALPPS) for primary hepatocellular carcinoma patients. Methods The date of 15 patients underwent the ALPPS in West China Hospital between Augst, 2014 and March, 2015 were retrospectively analyzed. The efficacy of the treatment was evaluated by blood test, the volume of residual liver growth, and postoperative follow-up. Results Fourteen cases underwent the complete ALPPS, 1 case lost because it couldn't match the standard for the second step. The median increase in the future liver remnant(FLR) volume was 205.5 cm³[(-7.92)-270.6 cm³] and the median rate of FLR increase was 56.5%[(-1.89%)-134.74%]. One case died in the perioperative period for the liver failure, 2 cases was found recurrence or metastasis and died in 3 and 4 months after operation, respectively. One case's AFP was found rising but no iconography evidence for recurrence. One case with tumor survival about 4 moths. The remaining 10 patients were alive without recurrence and metastasis. Conclusions ALPPS is a feasible strategy in patients with cirrhosis and can improve the resectability of hepatocellular carcinoma to provide a chance of a cure to those who would not otherwise be able to receive surgery. And we put out an indications and contradictions for ALPPS tentatively.

Citation： PENGChi-han, LIChuan, WENTian-fu, YANLü-nan, LIBo, YANGJia-yin, WANGWen-tao, XUMing-qing. Discussion about The Indications and Contradictions of ALPPS for Primary Hepatocellular Carcinoma Patients (Reports of 15 Cases). CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(10): 1183-1186. doi: 10.7507/1007-9424.20150308 Copy

1.	Ferrero A, Vigano L, Polastri R, et al. Postoperative liverdysfunction and future remnant liver:where is the limit? Results of a prospective study. World J Surg, 2007, 31(8):1643-1651.
2.	Tucker ON, Heaton N. The 'small for size' liver syndrome. Curr Opin Crit Care, 2005, 11(2):150-155.
3.	Schnitzbauer AA, Lang SA, Goessmann, et al. Right portal vein ligationcombined with in situ splitting induces rapid left lateral liver lobehypertrophy enabling two-staged extended right hepatic resection in small for size settings. Ann Surg, 2012, 255(3):405-414.
4.	Rahbari NN, Garden J, Padbury R, et al. Posthepatectomy liver failure:a definition and grading by the International Study Group of Liver Surgery(ISGLS). Surgery, 2011, 149(5):713-724.
5.	Ishak K, Baptista A, Bianchi L, et al. Histological grading and staging of chronic hepatitis. J Hepatol, 1995, 22(6):696-699.
6.	Rahbari NN, Garden OJ, Padbury R, et al. Post-hepatectomy haemorrhage:a definition and grading by the International Study Group of Liver Surgery (ISGLS). HPB (Oxford), 2011, 13(8):528-535.
7.	Dindo D, Demartines N, Clavien PA. Classification of surgical complications. Ann Surg, 2004, 240(2):205-213.
8.	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(5):521-527.
9.	Abulkhir A, Limongelli P, Healey AJ, et al. Preoperative portal vein embolizaion for major liver resection:a meta-analysis. Ann Surg, 2008, 247(1):49-57.
10.	Alvarez FA, Iniesta J, Lastiri J, et a.l. New method of hepatic regeneration. Cir Esp, 2011, 89(10):645-649.
11.	de Santibanes E, Alvarez FA, Ardiles V, et al. How to avoidpostoperative liver failure:a novel method. World J Surg, 2012, 36(1):125-128.
12.	Nadalin S, Capobianco I, Li J, et al. Indications and limits for associating liver partition and portal vein ligation for staged hepatectomy (ALPPS). Lessons Learned from 15 cases at a single centre. Z Gastroenterol, 2014, 52(1):35-42.
13.	Vennarecci G, Laurenzi A, Levi Sandri GB, et al. he ALPPS procedure for hepatocellular carcinoma, EJSO, 2014, 40(8):982-988.
14.	周俭, 王征, 孙健联, 等.合肝脏离断和门静脉结扎的二步肝切除术.中华消化外科杂志, 2013, 12(7):485-489.
15.	陈伟, 梁力建.联合肝脏离断和门静脉结扎的二步肝切除术在肝脏肿瘤治疗中的应用.中华普通外科学文献, 2014, 8(3):237-240.
16.	Tashiro S. Mechanism of liver regeneration after liver resection andportal vein embolization (ligation) is different? J Hepatobiliary Pancreat Surg, 2009, 16(3):292-299.
17.	Knoefel WT, Gabor I, Rehders A, et al. In situ liver transectionwith portal vein ligation for rapid growth of the future liver remnant in two-stage liver resection. Br J Surg, 2013, 100(3):388-394.
18.	Oldhafer KJ, Donati M, Jenner RM, et al. ALPPS for patients with colorectal liver metastases:effective liver hypertrophy, but early tumor recurrence. World J Surg, 201438(6):1504-1509.
19.	Sala S, Ardiles V, Ulla M, et al. Our initial experience with ALPPS technique:encouraging results. Updates Surg, 2012, 64(3):167-172.
20.	Alvarez FA, Ardiles V, Sanchez CR, et al. Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS):tips and tricks. J Gastrointest Surg, 2013, 17(4):814-821.
21.	Torres OJ, Fernandes Ede S, Oliveira CV, et al. Associating liver partitionand portal vein ligation for staged hepatectomy (ALPPS):the Brazilian experience. Arq Bras Cir Dig, 2013, 26(1):40-43.
22.	Li J, Girotti P, Königsrainer I, et al. ALPPS in right trisectionectomy:a safe procedure to avoid postoperative liver failure? J Gastrointest Surg, 2013, 17(5):956-961.
23.	de Santibañes E, Clavien PA. Playing Play-Doh to prevent postoperative liver failure:the "ALPPS" approach. Ann Surg, 2012, 255(3):415-417.
24.	Ratti F, Cipriani F, Gagliano A, et al. Defining indications to ALPPS procedure:technical aspects and open issues. Updates Surg, 2014, 66(1):41-49.

1. Ferrero A, Vigano L, Polastri R, et al. Postoperative liverdysfunction and future remnant liver:where is the limit? Results of a prospective study. World J Surg, 2007, 31(8):1643-1651.
2. Tucker ON, Heaton N. The 'small for size' liver syndrome. Curr Opin Crit Care, 2005, 11(2):150-155.
3. Schnitzbauer AA, Lang SA, Goessmann, et al. Right portal vein ligationcombined with in situ splitting induces rapid left lateral liver lobehypertrophy enabling two-staged extended right hepatic resection in small for size settings. Ann Surg, 2012, 255(3):405-414.
4. Rahbari NN, Garden J, Padbury R, et al. Posthepatectomy liver failure:a definition and grading by the International Study Group of Liver Surgery(ISGLS). Surgery, 2011, 149(5):713-724.
5. Ishak K, Baptista A, Bianchi L, et al. Histological grading and staging of chronic hepatitis. J Hepatol, 1995, 22(6):696-699.
6. Rahbari NN, Garden OJ, Padbury R, et al. Post-hepatectomy haemorrhage:a definition and grading by the International Study Group of Liver Surgery (ISGLS). HPB (Oxford), 2011, 13(8):528-535.
7. Dindo D, Demartines N, Clavien PA. Classification of surgical complications. Ann Surg, 2004, 240(2):205-213.
8. 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(5):521-527.
9. Abulkhir A, Limongelli P, Healey AJ, et al. Preoperative portal vein embolizaion for major liver resection:a meta-analysis. Ann Surg, 2008, 247(1):49-57.
10. Alvarez FA, Iniesta J, Lastiri J, et a.l. New method of hepatic regeneration. Cir Esp, 2011, 89(10):645-649.
11. de Santibanes E, Alvarez FA, Ardiles V, et al. How to avoidpostoperative liver failure:a novel method. World J Surg, 2012, 36(1):125-128.
12. Nadalin S, Capobianco I, Li J, et al. Indications and limits for associating liver partition and portal vein ligation for staged hepatectomy (ALPPS). Lessons Learned from 15 cases at a single centre. Z Gastroenterol, 2014, 52(1):35-42.
13. Vennarecci G, Laurenzi A, Levi Sandri GB, et al. he ALPPS procedure for hepatocellular carcinoma, EJSO, 2014, 40(8):982-988.
14. 周俭, 王征, 孙健联, 等.合肝脏离断和门静脉结扎的二步肝切除术.中华消化外科杂志, 2013, 12(7):485-489.
15. 陈伟, 梁力建.联合肝脏离断和门静脉结扎的二步肝切除术在肝脏肿瘤治疗中的应用.中华普通外科学文献, 2014, 8(3):237-240.
16. Tashiro S. Mechanism of liver regeneration after liver resection andportal vein embolization (ligation) is different? J Hepatobiliary Pancreat Surg, 2009, 16(3):292-299.
17. Knoefel WT, Gabor I, Rehders A, et al. In situ liver transectionwith portal vein ligation for rapid growth of the future liver remnant in two-stage liver resection. Br J Surg, 2013, 100(3):388-394.
18. Oldhafer KJ, Donati M, Jenner RM, et al. ALPPS for patients with colorectal liver metastases:effective liver hypertrophy, but early tumor recurrence. World J Surg, 201438(6):1504-1509.
19. Sala S, Ardiles V, Ulla M, et al. Our initial experience with ALPPS technique:encouraging results. Updates Surg, 2012, 64(3):167-172.
20. Alvarez FA, Ardiles V, Sanchez CR, et al. Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS):tips and tricks. J Gastrointest Surg, 2013, 17(4):814-821.
21. Torres OJ, Fernandes Ede S, Oliveira CV, et al. Associating liver partitionand portal vein ligation for staged hepatectomy (ALPPS):the Brazilian experience. Arq Bras Cir Dig, 2013, 26(1):40-43.
22. Li J, Girotti P, Königsrainer I, et al. ALPPS in right trisectionectomy:a safe procedure to avoid postoperative liver failure? J Gastrointest Surg, 2013, 17(5):956-961.
23. de Santibañes E, Clavien PA. Playing Play-Doh to prevent postoperative liver failure:the "ALPPS" approach. Ann Surg, 2012, 255(3):415-417.
24. Ratti F, Cipriani F, Gagliano A, et al. Defining indications to ALPPS procedure:technical aspects and open issues. Updates Surg, 2014, 66(1):41-49.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Discussion about The Indications and Contradictions of ALPPS for Primary Hepatocellular Carcinoma Patients (Reports of 15 Cases)

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content