Intraoperative Conversion to ALPPS in a Case of Intrahepatic Cholangiocarcinoma
Background. Surgical resection remains the best treatment option for intrahepatic cholangiocarcinoma (ICC). Two-stage liver resection combining in situ liver transection with portal vein ligation (ALPPS) has been described as a promising method to increase the resectability of liver tumors also in t...
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Wiley
2015-01-01
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| Series: | Case Reports in Surgery |
| Online Access: | http://dx.doi.org/10.1155/2015/273641 |
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| author | F. Oldhafer K. I. Ringe K. Timrott M. Kleine W. Ramackers S. Cammann M. D. Jäger J. Klempnauer H. Bektas F. W. R. Vondran |
| author_facet | F. Oldhafer K. I. Ringe K. Timrott M. Kleine W. Ramackers S. Cammann M. D. Jäger J. Klempnauer H. Bektas F. W. R. Vondran |
| author_sort | F. Oldhafer |
| collection | DOAJ |
| description | Background. Surgical resection remains the best treatment option for intrahepatic cholangiocarcinoma (ICC). Two-stage liver resection combining in situ liver transection with portal vein ligation (ALPPS) has been described as a promising method to increase the resectability of liver tumors also in the case of ICC. Presentation of Case. A 46-year-old male patient presented with an ICC-typical lesion in the right liver. The indication for primary liver resection was set and planed as a right hepatectomy. In contrast to the preoperative CT-scan, the known lesion showed further progression in a macroscopically steatotic liver. Therefore, the decision was made to perform an ALPPS-procedure to avoid an insufficient future liver remnant (FLR). The patient showed an uneventful postoperative course after the first and second step of the ALPPS-procedure, with sufficient increase of the FLR. Unfortunately, already 2.5 months after resection the patient had developed new tumor lesions found by the follow-up CT-scan. Discussion. The presented case demonstrates that an intraoperative conversion to an ALPPS-procedure is safely applicable when the FLR surprisingly seems to be insufficient. Conclusion. ALPPS should also be considered a treatment option in well-selected patients with ICC. However, the experience concerning the outcome of ALPPS in case of ICC remains fairly small. |
| format | Article |
| id | doaj-art-f8879c58eda34672a1876c75a5cbaf7a |
| institution | Kabale University |
| issn | 2090-6900 2090-6919 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Surgery |
| spelling | doaj-art-f8879c58eda34672a1876c75a5cbaf7a2025-02-03T05:50:59ZengWileyCase Reports in Surgery2090-69002090-69192015-01-01201510.1155/2015/273641273641Intraoperative Conversion to ALPPS in a Case of Intrahepatic CholangiocarcinomaF. Oldhafer0K. I. Ringe1K. Timrott2M. Kleine3W. Ramackers4S. Cammann5M. D. Jäger6J. Klempnauer7H. Bektas8F. W. R. Vondran9Regenerative Medicine & Experimental Surgery (ReMediES), Department of General, Visceral and Transplant Surgery, Hannover Medical School, 30625 Hannover, GermanyDepartment of Diagnostic and Interventional Radiology, Hannover Medical School, 30625 Hannover, GermanyRegenerative Medicine & Experimental Surgery (ReMediES), Department of General, Visceral and Transplant Surgery, Hannover Medical School, 30625 Hannover, GermanyRegenerative Medicine & Experimental Surgery (ReMediES), Department of General, Visceral and Transplant Surgery, Hannover Medical School, 30625 Hannover, GermanyRegenerative Medicine & Experimental Surgery (ReMediES), Department of General, Visceral and Transplant Surgery, Hannover Medical School, 30625 Hannover, GermanyRegenerative Medicine & Experimental Surgery (ReMediES), Department of General, Visceral and Transplant Surgery, Hannover Medical School, 30625 Hannover, GermanyRegenerative Medicine & Experimental Surgery (ReMediES), Department of General, Visceral and Transplant Surgery, Hannover Medical School, 30625 Hannover, GermanyRegenerative Medicine & Experimental Surgery (ReMediES), Department of General, Visceral and Transplant Surgery, Hannover Medical School, 30625 Hannover, GermanyRegenerative Medicine & Experimental Surgery (ReMediES), Department of General, Visceral and Transplant Surgery, Hannover Medical School, 30625 Hannover, GermanyRegenerative Medicine & Experimental Surgery (ReMediES), Department of General, Visceral and Transplant Surgery, Hannover Medical School, 30625 Hannover, GermanyBackground. Surgical resection remains the best treatment option for intrahepatic cholangiocarcinoma (ICC). Two-stage liver resection combining in situ liver transection with portal vein ligation (ALPPS) has been described as a promising method to increase the resectability of liver tumors also in the case of ICC. Presentation of Case. A 46-year-old male patient presented with an ICC-typical lesion in the right liver. The indication for primary liver resection was set and planed as a right hepatectomy. In contrast to the preoperative CT-scan, the known lesion showed further progression in a macroscopically steatotic liver. Therefore, the decision was made to perform an ALPPS-procedure to avoid an insufficient future liver remnant (FLR). The patient showed an uneventful postoperative course after the first and second step of the ALPPS-procedure, with sufficient increase of the FLR. Unfortunately, already 2.5 months after resection the patient had developed new tumor lesions found by the follow-up CT-scan. Discussion. The presented case demonstrates that an intraoperative conversion to an ALPPS-procedure is safely applicable when the FLR surprisingly seems to be insufficient. Conclusion. ALPPS should also be considered a treatment option in well-selected patients with ICC. However, the experience concerning the outcome of ALPPS in case of ICC remains fairly small.http://dx.doi.org/10.1155/2015/273641 |
| spellingShingle | F. Oldhafer K. I. Ringe K. Timrott M. Kleine W. Ramackers S. Cammann M. D. Jäger J. Klempnauer H. Bektas F. W. R. Vondran Intraoperative Conversion to ALPPS in a Case of Intrahepatic Cholangiocarcinoma Case Reports in Surgery |
| title | Intraoperative Conversion to ALPPS in a Case of Intrahepatic Cholangiocarcinoma |
| title_full | Intraoperative Conversion to ALPPS in a Case of Intrahepatic Cholangiocarcinoma |
| title_fullStr | Intraoperative Conversion to ALPPS in a Case of Intrahepatic Cholangiocarcinoma |
| title_full_unstemmed | Intraoperative Conversion to ALPPS in a Case of Intrahepatic Cholangiocarcinoma |
| title_short | Intraoperative Conversion to ALPPS in a Case of Intrahepatic Cholangiocarcinoma |
| title_sort | intraoperative conversion to alpps in a case of intrahepatic cholangiocarcinoma |
| url | http://dx.doi.org/10.1155/2015/273641 |
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