Achim Troja1, Karl Khatib-Chahidi2, Nader El-Sourani2, Dalibor Antolovic2, Hans-Rudolf Raab2. 1. European Medical School Oldenburg, University Department for General and Visceral Surgery, Klinikum Oldenburg, Germany. Electronic address: troja.achim@klinikum-oldenburg.de. 2. European Medical School Oldenburg, University Department for General and Visceral Surgery, Klinikum Oldenburg, Germany.
Abstract
BACKGROUND: The combination of right sided portal vein ligation and hepatic parenchymal transection thus inducing a hypertrophy of the left or left lateral sector is an innovative treatment option in treating locally advanced hepatic tumors or hepatic metastases. The available published data regarding this procedure is weak. We analyzed our own data regarding tumor recurrence and complications. The data was then used to be critically analyzed using the available published literature. METHODS: We treated n = 5 patients with an ALPPS (associating liver partition and portal vein ligation for staged hepatectomy). The follow-up was 3 years. We analyzed the perioperative period, complications, mortality and oncological survival rate. RESULTS: In all patients (n = 5) a R0-resection was achieved. N = 1 patient died postoperatively. N = 1 patient died 6 month later due to a pulmonary embolism. N = 3 patients had a tumor recurrence within 6 months. CONCLUSION: Selected patients can be successfully treated by ALPPS in terms of an R0-resection. However, risk of tumor recurrence and rate of complications are high.
BACKGROUND: The combination of right sided portal vein ligation and hepatic parenchymal transection thus inducing a hypertrophy of the left or left lateral sector is an innovative treatment option in treating locally advanced hepatic tumors or hepatic metastases. The available published data regarding this procedure is weak. We analyzed our own data regarding tumor recurrence and complications. The data was then used to be critically analyzed using the available published literature. METHODS: We treated n = 5 patients with an ALPPS (associating liver partition and portal vein ligation for staged hepatectomy). The follow-up was 3 years. We analyzed the perioperative period, complications, mortality and oncological survival rate. RESULTS: In all patients (n = 5) a R0-resection was achieved. N = 1 patient died postoperatively. N = 1 patient died 6 month later due to a pulmonary embolism. N = 3 patients had a tumor recurrence within 6 months. CONCLUSION: Selected patients can be successfully treated by ALPPS in terms of an R0-resection. However, risk of tumor recurrence and rate of complications are high.
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