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KMID : 0870420160200020075
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Korean Journal of Hepato-Biliary-Pancreatic Surgery
2016 Volume.20 No. 2 p.75 ~ p.80
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Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) procedure for hepatocellular carcinoma withchronic liver disease: a case report and review of literature
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Michail Papamichail
Michail Pizanias
Vincent Yip
Evangellos Prassas
Andreas Prachalias
Alberto Quaglia
Praveen Peddu
Nigel Heaton
Parthi Srinivasan
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Abstract
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The incidence of complications after liver resection is closely related to functional future liver remnant (FLR). The standard approach to augment FLR is surgical or radiological occlusion of the artery or portal vein on the tumor side. Associated liver partition and portal vein ligation for staged hepatectomy (ALLPS) has been introduced as an alternative method to augment FLR. It offers rapid and effective hypertrophy for resecting liver metastases. However, data regarding its application in patients with hepatocellular carcinoma (HCC) with a background of chronic liver disease are limited. Here we describe the use of ALPPS procedure to manage a large solitary HCC with a background of chronic liver disease. The rising incidence of HCC has increased the number of surgical resections in patients with advanced stage liver disease not considered for liver transplantation. We reviewed reported experience of ALPPS in established chronic liver disease and current therapeutic modalities for HCC on a background of chronic liver disease in patients with potential liver insufficiency where tumor burden is beyond liver transplant criteria.
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KEYWORD
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ALPPS, Liver cirrhosis
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