Rescue ALPPS: Intraoperative Conversion to ALPPS during Synchronous Resection of Rectal Cancer and Liver Metastasis
Future liver remnant (FLR) is the most important deciding factor in planning for liver resection. Portal vein embolization (PVE) was first introduced in the 1980s to induce liver hypertrophy, enabling removal of multiple/bilobar tumors. PVE was later combined with sequential hepatectomies with the a...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2014-01-01
|
| Series: | Case Reports in Surgery |
| Online Access: | http://dx.doi.org/10.1155/2014/487852 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832559269456642048 |
|---|---|
| author | Terence Jackson Kelly A. Siegel Christopher T. Siegel |
| author_facet | Terence Jackson Kelly A. Siegel Christopher T. Siegel |
| author_sort | Terence Jackson |
| collection | DOAJ |
| description | Future liver remnant (FLR) is the most important deciding factor in planning for liver resection. Portal vein embolization (PVE) was first introduced in the 1980s to induce liver hypertrophy, enabling removal of multiple/bilobar tumors. PVE was later combined with sequential hepatectomies with the aim of allowing the liver remnant to hypertrophy (15–20%) between procedures. However, the interval between the two procedures (3–8 weeks) put patients at risk for disease progression. With portal vein ligation alone or when combined with sequential hepatectomy, there is also a risk for inadequate liver hypertrophy because of intrahepatic portal collaterals leading to a high (19–30%) dropout rate. The ALPPS procedure (associating liver partition and portal vein ligation for staged hepatectomy) was recently developed as a feasible means to perform extensive/bilobar liver resections. It produces rapid, enormous hypertrophy of the remnant, making previously unresectable lesions resectable. Indications for ALPPS include any extensive liver resection with inadequate FLR. Here we present a novel indication for ALPPS as a rescue when inadequate FLR was faced intraoperatively, during a simultaneous resection of rectal primary and liver metastasis. |
| format | Article |
| id | doaj-art-3b25f8d361ee440ea3a9fb041b9e6589 |
| institution | Kabale University |
| issn | 2090-6900 2090-6919 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Surgery |
| spelling | doaj-art-3b25f8d361ee440ea3a9fb041b9e65892025-02-03T01:30:27ZengWileyCase Reports in Surgery2090-69002090-69192014-01-01201410.1155/2014/487852487852Rescue ALPPS: Intraoperative Conversion to ALPPS during Synchronous Resection of Rectal Cancer and Liver MetastasisTerence Jackson0Kelly A. Siegel1Christopher T. Siegel2Department of Surgery, University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USADivision of Hepatobiliary and Transplant Surgery, Department of Surgery, University Hospitals Case Medical Center, Cleveland, OH 44106, USADivision of Hepatobiliary and Transplant Surgery, Department of Surgery, University Hospitals Case Medical Center, Cleveland, OH 44106, USAFuture liver remnant (FLR) is the most important deciding factor in planning for liver resection. Portal vein embolization (PVE) was first introduced in the 1980s to induce liver hypertrophy, enabling removal of multiple/bilobar tumors. PVE was later combined with sequential hepatectomies with the aim of allowing the liver remnant to hypertrophy (15–20%) between procedures. However, the interval between the two procedures (3–8 weeks) put patients at risk for disease progression. With portal vein ligation alone or when combined with sequential hepatectomy, there is also a risk for inadequate liver hypertrophy because of intrahepatic portal collaterals leading to a high (19–30%) dropout rate. The ALPPS procedure (associating liver partition and portal vein ligation for staged hepatectomy) was recently developed as a feasible means to perform extensive/bilobar liver resections. It produces rapid, enormous hypertrophy of the remnant, making previously unresectable lesions resectable. Indications for ALPPS include any extensive liver resection with inadequate FLR. Here we present a novel indication for ALPPS as a rescue when inadequate FLR was faced intraoperatively, during a simultaneous resection of rectal primary and liver metastasis.http://dx.doi.org/10.1155/2014/487852 |
| spellingShingle | Terence Jackson Kelly A. Siegel Christopher T. Siegel Rescue ALPPS: Intraoperative Conversion to ALPPS during Synchronous Resection of Rectal Cancer and Liver Metastasis Case Reports in Surgery |
| title | Rescue ALPPS: Intraoperative Conversion to ALPPS during Synchronous Resection of Rectal Cancer and Liver Metastasis |
| title_full | Rescue ALPPS: Intraoperative Conversion to ALPPS during Synchronous Resection of Rectal Cancer and Liver Metastasis |
| title_fullStr | Rescue ALPPS: Intraoperative Conversion to ALPPS during Synchronous Resection of Rectal Cancer and Liver Metastasis |
| title_full_unstemmed | Rescue ALPPS: Intraoperative Conversion to ALPPS during Synchronous Resection of Rectal Cancer and Liver Metastasis |
| title_short | Rescue ALPPS: Intraoperative Conversion to ALPPS during Synchronous Resection of Rectal Cancer and Liver Metastasis |
| title_sort | rescue alpps intraoperative conversion to alpps during synchronous resection of rectal cancer and liver metastasis |
| url | http://dx.doi.org/10.1155/2014/487852 |
| work_keys_str_mv | AT terencejackson rescuealppsintraoperativeconversiontoalppsduringsynchronousresectionofrectalcancerandlivermetastasis AT kellyasiegel rescuealppsintraoperativeconversiontoalppsduringsynchronousresectionofrectalcancerandlivermetastasis AT christophertsiegel rescuealppsintraoperativeconversiontoalppsduringsynchronousresectionofrectalcancerandlivermetastasis |