1. Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy (ALPPS) procedure for colorectal liver metastasis
- Author
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Roberto Hernandez-Alejandro, Luis I. Ruffolo, Alejandro Serrablo, Orlando Jorge M Torres, Bergthor Björnsson, and Ruslan Alikhanov
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Portal vein ligation ,030230 surgery ,Metastasis ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Hepatectomy ,Humans ,Stage (cooking) ,Ligation ,Portal Vein ,business.industry ,Liver Neoplasms ,General Medicine ,Perioperative ,medicine.disease ,Surgery ,Treatment Outcome ,Liver ,Two stage hepatectomy ,030220 oncology & carcinogenesis ,Risk stratification ,Colorectal Neoplasms ,business - Abstract
Since first described, Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy (ALPPS) has garnered boisterous praise and fervent criticism. Its rapid adoption and employment for a variety of indications resulted in high perioperative morbidity and mortality. However recent risk stratification, refinement of technique to reduce the impact of stage I and progression along the learning curve have resulted in improved outcomes. The first randomized trial comparing ALPPS to two stage hepatectomy (TSH) for colorectal liver metastases (CRLM) was recently published demonstrating comparable perioperative morbidity and mortality with improved resectability and survival following ALPPS. In this review, as ALPPS enters the thirteenth year since conception, the current status of this contentious two stage technique is presented and best practices for deployment in the treatment of CRLM is codified.
- Published
- 2020