Daisuke Kawaguchi1, Yukihiko Hiroshima1, Kenichi Matsuo1, Itaru Endo2, Keiji Koda1, Kuniya Tanaka3. 1. Department of Surgery, Teikyo University Chiba Medical Center, Chiba, Japan. 2. Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan. 3. Department of Surgery, Teikyo University Chiba Medical Center, Chiba, Japan U17-92TS@med.teikyo-u.ac.jp.
Abstract
AIM: To evaluate whether the congested area that develops in associating liver partition with portal vein ligation for staged hepatectomy (ALPPS) contributes to rapid future liver remnant (FLR) hypertrophy. PATIENTS AND METHODS: Eight patients undergoing liver partition and right portal vein (RPV) ligation within the FLR in the first operation of ALPPS were compared with eight patients undergoing RPV embolization in the FLR as the first operation of classical two-stage (CTS) hepatectomy. RESULTS: Extrapolated kinetic growth of the FLR in ALPPS was 32.7±18.7 ml/day, 7.8-times that in CTS (4.2±2.0 ml/day, p=0.001). Extrapolated kinetic reduction in volume of the ventral aspect of the right paramedian sector, which became congested after the first procedure in ALPPS, was 19.8±11.6 ml/day, 11-times that in CTS (1.8±1.3 ml/day, p=0.001). CONCLUSION: Production of a congested area within the deportalized liver may contribute importantly to rapid FLR hypertrophy during ALPPS. Copyright
AIM: To evaluate whether the congested area that develops in associating liver partition with portal vein ligation for staged hepatectomy (ALPPS) contributes to rapid future liver remnant (FLR) hypertrophy. PATIENTS AND METHODS: Eight patients undergoing liver partition and right portal vein (RPV) ligation within the FLR in the first operation of ALPPS were compared with eight patients undergoing RPV embolization in the FLR as the first operation of classical two-stage (CTS) hepatectomy. RESULTS: Extrapolated kinetic growth of the FLR in ALPPS was 32.7±18.7 ml/day, 7.8-times that in CTS (4.2±2.0 ml/day, p=0.001). Extrapolated kinetic reduction in volume of the ventral aspect of the right paramedian sector, which became congested after the first procedure in ALPPS, was 19.8±11.6 ml/day, 11-times that in CTS (1.8±1.3 ml/day, p=0.001). CONCLUSION: Production of a congested area within the deportalized liver may contribute importantly to rapid FLR hypertrophy during ALPPS. Copyright