Future liver remnant portal or hepatic vein reconstruction at stage I of ALPPS—How far can we push the boundaries?. Issue 4 (16th July 2019)

• Record Type: Journal Article
• Authors: Schlegel, Andrea; Sakuraoka, Yuhki; Kalisvaart, Marit; Coldham, Chris; Isaac, John; Muiesan, Paolo
• Is Part Of: Journal of surgical oncology. Volume 120:Issue 4(2019)
• Page Start: 654
• Page End: 660
• Publication Date: 2019-07-16
• Subjects: ALPPS -- delayed PVE -- outcome -- total vascular exclusion -- venous reconstruction; Cancer -- Surgery -- Periodicals; Neoplasms -- Periodicals; 616
• DOI: 10.1002/jso.25618
• Languages: English
• ISSNs: 0022-4790

Abstract

Abstract: Preservation of the future liver remnant (FLR) vascular integrity has always been considered crucial to achieving successful liver growths after major hepatectomies. Most surgeons appeared therefore reluctant to combine stage I of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) with vascular reconstructions. Here we describe a case series, where we combine parenchymal transection and venous in‐ or outflow reconstruction of the FLR at stage I of ALPPS. In addition, the cold flush of the FLR or delayed portal vein embolization is applied in selected cases.