Progress of associating liver partition and portal vein ligation for staged hepatectomy evolution_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

XU Banghao ¹ , LAN Zhujing ¹ , ZHU Hai ¹ , WANG Jilong ¹ , LU Tingting ² , ZHANG Ling ³ , GUO Ya ¹ , PENG Minhao ¹ ,  WEN Zhang ¹

1. Department of Hepatobiliary Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, P. R. China;
2. Department of Ultrasound, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, P. R. China;
3. Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, P. R. China;

Corresponding author：

WEN Zhang, Email: wenzgxmu@163.com

Keywords：

liver cancer; associating liver partition and portal vein ligation for staged hepatectomy; future liver remnant; liver regeneration

DOI：

10.7507/1007-9424.202303039

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To summarize the progress of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) and evolution of surgical procedure improvement, so as to summarize experience in selecting appropriate surgical method for patients. Method The domestic and foreign literature on the evolution of ALPPS surgical procedure improvement in recent years was reviewed. Results In the decade since the emergence of ALPPS, the ALPPS had been rapidly developed in the hepatobiliary surgery. The ALPPS promoted a rapid increase in future liver remnant during a relatively shorter period to contribute to resectability of liver tumors and reduce the rate of postoperative liver failure, the patients with intermediate to advanced and huge liver cancer could obtain the surgical radical resection. In recent years, the domestic and foreign experts had refined the ALPPS procedure, which mainly focused on the operation of hepatic section separation and hepatic artery flow restriction in stage Ⅰ surgery, including partial ALPPS, radiofrequency ablation ALPPS, tourniquet ALPPS, transcatheter arterial embolization ALPPS, hepatic artery ringed and operation ALPPS, as well as laparoscopic ALPPS and robotic ALPPS with minimally invasive approach. Conclusions Despite the ongoing controversy over ALPPS, with the continuous progress and innovation of improved procedures and the utilization of laparoscope and robot in surgery, the trauma of ALPPS surgery has a further reduction, and the morbidity and mortality have gradually been decreased. It is believed that with the continuous advancement and improvement of ALPPS surgery technology, the indications and safety of ALPPS will be further enhanced, bringing hope to more patients with intermediate to advanced liver cancer with huge tumors.

Citation： XU Banghao, LAN Zhujing, ZHU Hai, WANG Jilong, LU Tingting, ZHANG Ling, GUO Ya, PENG Minhao, WEN Zhang. Progress of associating liver partition and portal vein ligation for staged hepatectomy evolution. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2023, 30(7): 870-876. doi: 10.7507/1007-9424.202303039 Copy

1.	Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
2.	Zheng R, Qu C, Zhang S, et al. Liver cancer incidence and mortality in China: temporal trends and projections to 2030. Chin J Cancer Res, 2018, 30(6): 571-579.
3.	Kawaguchi Y, Honda G, Endo I, et al. Current technical issues for surgery of primary liver cancer. Liver Cancer, 2016, 6(1): 51-58.
4.	四川大学华西医院肝癌MDT团队. 肝细胞肝癌全程多学科规范化管理: 华西医院多学科专家共识(第二版). 中国普外基础与临床杂志, 2020, 27(9): 1062-1077.
5.	van Mierlo KM, Schaap FG, Dejong CH, et al. Liver resection for cancer: new developments in prediction, prevention and manage-ment of postresectional liver failure. J Hepatol, 2016, 65(6): 1217-1231.
6.	奉建祁, 王志明. 中晚期原发性肝癌治疗的新进展. 中国普通外科杂志, 2021, 30(7): 847-857.
7.	Lang SA, Loss M, Schlitt HJ. “In-situ split” (ISS) liver resection: new aspects of technique and indication. Zentralbl Chir, 2014, 139(2): 212-219.
8.	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(3): 405-414.
9.	周俭, 王征, 孙健, 等. 联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.
10.	Schadde E, Ardiles V, Robles-Campos R, et al. Early survival and safety of ALPPS: first report of the International ALPPS Registry. Ann Surg, 2014, 260(5): 829-836.
11.	Sparrelid E, Hasselgren K, Røsok BI, et al. How should liver hypertrophy be stimulated? A comparison of upfront associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) and portal vein embolization (PVE) with rescue possibility. Hepatobiliary Surg Nutr, 2021, 10(1): 1-8.
12.	Li J, Ewald F, Gulati A, et al. Associating liver partition and portal vein ligation for staged hepatectomy: from technical evolution to oncological benefit. World J Gastrointest Surg, 2016, 8(2): 124-133.
13.	Linecker M, Björnsson B, Stavrou GA, et al. Risk adjustment in ALPPS is associated with a dramatic decrease in early mortality and morbidity. Ann Surg, 2017, 266(5): 779-786.
14.	中华人民共和国国家卫生健康委员会医政医管局. 原发性肝癌诊疗指南(2022年版). 中国实用外科杂志, 2022, 42(3): 241-273.
15.	Liu JG, Wang J, Sun W, et al. ALPPS in the treatment of liver cancer with insufficient future liver remnant. Hepatobiliary Pancreat Dis Int, 2021, 20(4): 400-402.
16.	Alvarez FA, Ardiles V, Sanchez Claria R, et al. Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS): tips and tricks. J Gastrointest Surg, 2013, 17(4): 814-821.
17.	Alvarez FA, Ardiles V, de Santibañes M, et al. Associating liver partition and portal vein ligation for staged hepatectomy offers high oncological feasibility with adequate patient safety: a prospective study at a single center. Ann Surg, 2015, 261(4): 723-732.
18.	Petrowsky H, Györi G, de Oliveira M, et al. Is partial-ALPPS safer than ALPPS? A single-center experience. Ann Surg, 2015, 261(4): e90-e92. doi: 10.1097/SLA.0000000000001087.
19.	Wu X, Rao J, Zhou X, et al. Partial ALPPS versus complete ALPPS for staged hepatectomy. BMC Gastroenterol, 2019, 19(1): 170. doi: 10.1186/s12876-019-1090-1.
20.	Linecker M, Kambakamba P, Reiner CS, et al. How much liver needs to be transected in ALPPS? A translational study investigating the concept of less invasiveness. Surgery, 2017, 161(2): 453-464.
21.	Chan ACY, Chok K, Dai JWC, et al. Impact of split completeness on future liver remnant hypertrophy in associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) in hepatocellular carcinoma: complete-ALPPS versus partial-ALPPS. Surgery, 2017, 161(2): 357-364.
22.	Jiao LR, Fajardo Puerta AB, Gall TMH, et al. Rapid induction of liver regeneration for major hepatectomy (REBIRTH): a randomized controlled trial of portal vein embolisation versus ALPPS assisted with radiofrequency. Cancers (Basel), 2019, 11(3): 302. doi: 10.3390/cancers11030302.
23.	Wang Q, Yan J, Feng X, et al. Safety and efficacy of radiofrequency-assisted ALPPS (RALPPS) in patients with cirrhosis-related hepatocellular carcinoma. Int J Hyperthermia, 2017, 33(7): 846-852.
24.	Zhang J, Huang H, Bian J, et al. Safety, feasibility, and efficacy of associating liver partition and portal vein ligation for staged hepatectomy in treating hepatocellular carcinoma: a systematic review. Ann Transl Med, 2020, 8(19): 1246. doi: 10.21037/atm-20-2214.
25.	Gringeri E, Boetto R, D’Amico FE, et al. Laparoscopic microwave ablation and portal vein ligation for staged hepatectomy (LAPS): a minimally invasive first-step approach. Ann Surg, 2015, 261(2): e42-e43. doi: 10.1097/SLA.0000000000000606.
26.	Gall TM, Sodergren MH, Frampton AE, et al. Radio-frequency-assisted Liver Partition with Portal vein ligation (RALPP) for liver regeneration. Ann Surg, 2015, 261(2): e45-e46. doi: 10.1097/SLA.0000000000000607.
27.	Zhang Y, Yang H, Chen Y, et al. Totally laparoscopic associating liver tourniquet and portal ligation for staged hepatectomy via anterior approach for cirrhotic hepatocellular carcinoma. J Am Coll Surg, 2015, 221(2): e43-e48. doi: 10.1016/j.jamcollsurg.2015.04.016.
28.	Tanaka K. Modified ALPPS procedures: more safety through less invasive surgery. Langenbecks Arch Surg, 2017, 402(4): 563-574.
29.	Robles-Campos R, Brusadin R, López-Conesa A, et al. Long-term outcome after conventional two-stage hepatectomy versus tourniquet-ALPPS in colorectal liver metastases: a propensity score matching analysis. World J Surg, 2019, 43(9): 2281-2289.
30.	Robles R, Parrilla P, López-Conesa A, et al. Tourniquet modification of the associating liver partition and portal ligation for staged hepatectomy procedure. Br J Surg, 2014, 101(9): 1129-1134.
31.	Wang Z, Peng Y, Sun Q, et al. Salvage transhepatic arterial embolization after failed stage Ⅰ ALPPS in a patient with a huge HCC with chronic liver disease: a case report. Int J Surg Case Rep, 2017, 39: 131-135.
32.	Peng Y, Wang Z, Qu X, et al. Transcatheter arterial embolization-salvaged ALPPS, a novel ALPPS procedure especially for patients with hepatocellular carcinoma and severe fibrosis/cirrhosis. Hepatobiliary Surg Nutr, 2022, 11(4): 504-514.
33.	文张, 徐邦浩, 王继龙, 等. 肝动脉戴戒限流术联合肝脏分隔和门静脉结扎的二步肝切除术治疗巨块型肝癌的临床疗效. 中华消化外科杂志, 2019, 18(5): 489-498.
34.	Ye C, Zhang L, Xu B, et al. Hepatic arterioportal fistula is associated with decreased future liver remnant regeneration after stage-Ⅰ ALPPS for hepatocellular carcinoma. J Gastrointest Surg, 2021, 25(9): 2280-2288.
35.	Machado MA, Makdissi FF, Surjan RC. Totally laparoscopic ALPPS is feasible and may be worthwhile. Ann Surg, 2012, 256(3): e13. doi: 10.1097/SLA.0b013e318265ff2e.
36.	Xiao L, Li JW, Zheng SG. Totally laparoscopic ALPPS in the treatment of cirrhotic hepatocellular carcinoma. Surg Endosc, 2015, 29(9): 2800-2801.
37.	Ferko A, Vojtko M, Adámik M, et al. Totally laparoscopic ALPPS: bilobar procedure with preservation of the S3 portobiliary triad. Ann Surg Oncol, 2019, 26(1): 291. doi: 10.1245/s10434-018-6930-7.
38.	Machado MA, Makdissi FF, Surjan RC, et al. Transition from open to laparoscopic ALPPS for patients with very small FLR: the initial experience. HPB (Oxford), 2017, 19(1): 59-66.
39.	Melandro F, Giovanardi F, Hassan R, et al. Minimally invasive approach in the setting of ALPPS procedure: a systematic review of the literature. J Gastrointest Surg, 2019, 23(9): 1917-1924.
40.	Michal K, Sau M, Tamara GMH, et al. A better route to ALPPS: minimally invasive vs open ALPPS. Surg Endosc, 2020, 34(6): 2379-2389.
41.	Vicente E, Quijano Y, Ielpo B, et al. First ALPPS procedure using a total robotic approach. Surg Oncol, 2016, 25(4): 457. doi: 10.1016/j.suronc.2015.10.001.
42.	Machado MAC, Surjan RC, Makdissi F. Robotic ALPPS. Ann Surg Oncol, 2020, 27(4): 1174-1179.
43.	Hu MG, Wang J, Yin ZZ, et al. First two-stage robotic ALPPS in HCC patients with hepatic vein invasion: a step-by-step procedure from a clinical case. World J Surg Oncol, 2021, 19(1): 58. doi: 10.1186/s12957-021-02170-0.
44.	Sun Z, Tang W, Sakamoto Y, et al. A systematic review and meta-analysis of feasibility, safety and efficacy of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) versus two-stage hepatectomy (TSH). Biosci Trends, 2015, 9(5): 284-288.
45.	Chan A, Zhang WY, Chok K, et al. ALPPS versus portal vein embolization for hepatitis-related hepatocellular carcinoma: a changing paradigm in modulation of future liver remnant before major hepatectomy. Ann Surg, 2021, 273(5): 957-965.
46.	曹彦龙, 王桂杰, 李巍. ALPPS与门静脉栓塞二步法肝切除术治疗剩余肝体积不足的肝脏恶性肿瘤的临床疗效的Meta分析. 中华外科杂志, 2019, 57(7): 540-548.
47.	Deng Z, Jin Z, Qin Y, et al. Efficacy of the association liver partition and portal vein ligation for staged hepatectomy for the treatment of solitary huge hepatocellular carcinoma: a retrospective single-center study. World J Surg Oncol, 2021, 19(1): 95. doi: 10.1186/s12957-021-02199-1.
48.	Li PP, Huang G, Jia NY, et al. Associating liver partition and portal vein ligation for staged hepatectomy versus sequential transarterial chemoembolization and portal vein embolization in staged hepatectomy for HBV-related hepatocellular carcinoma: a randomized comparative study. Hepatobiliary Surg Nutr, 2022, 11(1): 38-51.

1. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
2. Zheng R, Qu C, Zhang S, et al. Liver cancer incidence and mortality in China: temporal trends and projections to 2030. Chin J Cancer Res, 2018, 30(6): 571-579.
3. Kawaguchi Y, Honda G, Endo I, et al. Current technical issues for surgery of primary liver cancer. Liver Cancer, 2016, 6(1): 51-58.
4. 四川大学华西医院肝癌MDT团队. 肝细胞肝癌全程多学科规范化管理: 华西医院多学科专家共识(第二版). 中国普外基础与临床杂志, 2020, 27(9): 1062-1077.
5. van Mierlo KM, Schaap FG, Dejong CH, et al. Liver resection for cancer: new developments in prediction, prevention and manage-ment of postresectional liver failure. J Hepatol, 2016, 65(6): 1217-1231.
6. 奉建祁, 王志明. 中晚期原发性肝癌治疗的新进展. 中国普通外科杂志, 2021, 30(7): 847-857.
7. Lang SA, Loss M, Schlitt HJ. “In-situ split” (ISS) liver resection: new aspects of technique and indication. Zentralbl Chir, 2014, 139(2): 212-219.
8. 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(3): 405-414.
9. 周俭, 王征, 孙健, 等. 联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.
10. Schadde E, Ardiles V, Robles-Campos R, et al. Early survival and safety of ALPPS: first report of the International ALPPS Registry. Ann Surg, 2014, 260(5): 829-836.
11. Sparrelid E, Hasselgren K, Røsok BI, et al. How should liver hypertrophy be stimulated? A comparison of upfront associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) and portal vein embolization (PVE) with rescue possibility. Hepatobiliary Surg Nutr, 2021, 10(1): 1-8.
12. Li J, Ewald F, Gulati A, et al. Associating liver partition and portal vein ligation for staged hepatectomy: from technical evolution to oncological benefit. World J Gastrointest Surg, 2016, 8(2): 124-133.
13. Linecker M, Björnsson B, Stavrou GA, et al. Risk adjustment in ALPPS is associated with a dramatic decrease in early mortality and morbidity. Ann Surg, 2017, 266(5): 779-786.
14. 中华人民共和国国家卫生健康委员会医政医管局. 原发性肝癌诊疗指南(2022年版). 中国实用外科杂志, 2022, 42(3): 241-273.
15. Liu JG, Wang J, Sun W, et al. ALPPS in the treatment of liver cancer with insufficient future liver remnant. Hepatobiliary Pancreat Dis Int, 2021, 20(4): 400-402.
16. Alvarez FA, Ardiles V, Sanchez Claria R, et al. Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS): tips and tricks. J Gastrointest Surg, 2013, 17(4): 814-821.
17. Alvarez FA, Ardiles V, de Santibañes M, et al. Associating liver partition and portal vein ligation for staged hepatectomy offers high oncological feasibility with adequate patient safety: a prospective study at a single center. Ann Surg, 2015, 261(4): 723-732.
18. Petrowsky H, Györi G, de Oliveira M, et al. Is partial-ALPPS safer than ALPPS? A single-center experience. Ann Surg, 2015, 261(4): e90-e92. doi: 10.1097/SLA.0000000000001087.
19. Wu X, Rao J, Zhou X, et al. Partial ALPPS versus complete ALPPS for staged hepatectomy. BMC Gastroenterol, 2019, 19(1): 170. doi: 10.1186/s12876-019-1090-1.
20. Linecker M, Kambakamba P, Reiner CS, et al. How much liver needs to be transected in ALPPS? A translational study investigating the concept of less invasiveness. Surgery, 2017, 161(2): 453-464.
21. Chan ACY, Chok K, Dai JWC, et al. Impact of split completeness on future liver remnant hypertrophy in associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) in hepatocellular carcinoma: complete-ALPPS versus partial-ALPPS. Surgery, 2017, 161(2): 357-364.
22. Jiao LR, Fajardo Puerta AB, Gall TMH, et al. Rapid induction of liver regeneration for major hepatectomy (REBIRTH): a randomized controlled trial of portal vein embolisation versus ALPPS assisted with radiofrequency. Cancers (Basel), 2019, 11(3): 302. doi: 10.3390/cancers11030302.
23. Wang Q, Yan J, Feng X, et al. Safety and efficacy of radiofrequency-assisted ALPPS (RALPPS) in patients with cirrhosis-related hepatocellular carcinoma. Int J Hyperthermia, 2017, 33(7): 846-852.
24. Zhang J, Huang H, Bian J, et al. Safety, feasibility, and efficacy of associating liver partition and portal vein ligation for staged hepatectomy in treating hepatocellular carcinoma: a systematic review. Ann Transl Med, 2020, 8(19): 1246. doi: 10.21037/atm-20-2214.
25. Gringeri E, Boetto R, D’Amico FE, et al. Laparoscopic microwave ablation and portal vein ligation for staged hepatectomy (LAPS): a minimally invasive first-step approach. Ann Surg, 2015, 261(2): e42-e43. doi: 10.1097/SLA.0000000000000606.
26. Gall TM, Sodergren MH, Frampton AE, et al. Radio-frequency-assisted Liver Partition with Portal vein ligation (RALPP) for liver regeneration. Ann Surg, 2015, 261(2): e45-e46. doi: 10.1097/SLA.0000000000000607.
27. Zhang Y, Yang H, Chen Y, et al. Totally laparoscopic associating liver tourniquet and portal ligation for staged hepatectomy via anterior approach for cirrhotic hepatocellular carcinoma. J Am Coll Surg, 2015, 221(2): e43-e48. doi: 10.1016/j.jamcollsurg.2015.04.016.
28. Tanaka K. Modified ALPPS procedures: more safety through less invasive surgery. Langenbecks Arch Surg, 2017, 402(4): 563-574.
29. Robles-Campos R, Brusadin R, López-Conesa A, et al. Long-term outcome after conventional two-stage hepatectomy versus tourniquet-ALPPS in colorectal liver metastases: a propensity score matching analysis. World J Surg, 2019, 43(9): 2281-2289.
30. Robles R, Parrilla P, López-Conesa A, et al. Tourniquet modification of the associating liver partition and portal ligation for staged hepatectomy procedure. Br J Surg, 2014, 101(9): 1129-1134.
31. Wang Z, Peng Y, Sun Q, et al. Salvage transhepatic arterial embolization after failed stage Ⅰ ALPPS in a patient with a huge HCC with chronic liver disease: a case report. Int J Surg Case Rep, 2017, 39: 131-135.
32. Peng Y, Wang Z, Qu X, et al. Transcatheter arterial embolization-salvaged ALPPS, a novel ALPPS procedure especially for patients with hepatocellular carcinoma and severe fibrosis/cirrhosis. Hepatobiliary Surg Nutr, 2022, 11(4): 504-514.
33. 文张, 徐邦浩, 王继龙, 等. 肝动脉戴戒限流术联合肝脏分隔和门静脉结扎的二步肝切除术治疗巨块型肝癌的临床疗效. 中华消化外科杂志, 2019, 18(5): 489-498.
34. Ye C, Zhang L, Xu B, et al. Hepatic arterioportal fistula is associated with decreased future liver remnant regeneration after stage-Ⅰ ALPPS for hepatocellular carcinoma. J Gastrointest Surg, 2021, 25(9): 2280-2288.
35. Machado MA, Makdissi FF, Surjan RC. Totally laparoscopic ALPPS is feasible and may be worthwhile. Ann Surg, 2012, 256(3): e13. doi: 10.1097/SLA.0b013e318265ff2e.
36. Xiao L, Li JW, Zheng SG. Totally laparoscopic ALPPS in the treatment of cirrhotic hepatocellular carcinoma. Surg Endosc, 2015, 29(9): 2800-2801.
37. Ferko A, Vojtko M, Adámik M, et al. Totally laparoscopic ALPPS: bilobar procedure with preservation of the S3 portobiliary triad. Ann Surg Oncol, 2019, 26(1): 291. doi: 10.1245/s10434-018-6930-7.
38. Machado MA, Makdissi FF, Surjan RC, et al. Transition from open to laparoscopic ALPPS for patients with very small FLR: the initial experience. HPB (Oxford), 2017, 19(1): 59-66.
39. Melandro F, Giovanardi F, Hassan R, et al. Minimally invasive approach in the setting of ALPPS procedure: a systematic review of the literature. J Gastrointest Surg, 2019, 23(9): 1917-1924.
40. Michal K, Sau M, Tamara GMH, et al. A better route to ALPPS: minimally invasive vs open ALPPS. Surg Endosc, 2020, 34(6): 2379-2389.
41. Vicente E, Quijano Y, Ielpo B, et al. First ALPPS procedure using a total robotic approach. Surg Oncol, 2016, 25(4): 457. doi: 10.1016/j.suronc.2015.10.001.
42. Machado MAC, Surjan RC, Makdissi F. Robotic ALPPS. Ann Surg Oncol, 2020, 27(4): 1174-1179.
43. Hu MG, Wang J, Yin ZZ, et al. First two-stage robotic ALPPS in HCC patients with hepatic vein invasion: a step-by-step procedure from a clinical case. World J Surg Oncol, 2021, 19(1): 58. doi: 10.1186/s12957-021-02170-0.
44. Sun Z, Tang W, Sakamoto Y, et al. A systematic review and meta-analysis of feasibility, safety and efficacy of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) versus two-stage hepatectomy (TSH). Biosci Trends, 2015, 9(5): 284-288.
45. Chan A, Zhang WY, Chok K, et al. ALPPS versus portal vein embolization for hepatitis-related hepatocellular carcinoma: a changing paradigm in modulation of future liver remnant before major hepatectomy. Ann Surg, 2021, 273(5): 957-965.
46. 曹彦龙, 王桂杰, 李巍. ALPPS与门静脉栓塞二步法肝切除术治疗剩余肝体积不足的肝脏恶性肿瘤的临床疗效的Meta分析. 中华外科杂志, 2019, 57(7): 540-548.
47. Deng Z, Jin Z, Qin Y, et al. Efficacy of the association liver partition and portal vein ligation for staged hepatectomy for the treatment of solitary huge hepatocellular carcinoma: a retrospective single-center study. World J Surg Oncol, 2021, 19(1): 95. doi: 10.1186/s12957-021-02199-1.
48. Li PP, Huang G, Jia NY, et al. Associating liver partition and portal vein ligation for staged hepatectomy versus sequential transarterial chemoembolization and portal vein embolization in staged hepatectomy for HBV-related hepatocellular carcinoma: a randomized comparative study. Hepatobiliary Surg Nutr, 2022, 11(1): 38-51.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Progress of associating liver partition and portal vein ligation for staged hepatectomy evolution

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