Abstract
Aim of this study is to assess the incidence and outcome of small for size syndrome after ALPPS procedure. This novel procedure is claimed to induce accelerated and increased growth of future liver remnant after major hepatectomies. We prospectively collected data on nine consecutive patients undergoing ALPPS procedure at our center. Main patients’ characteristics, outcome and postoperative complications, including small for size syndrome were analyzed. Main interval between two stages of ALPPS was 15.1 days. Mean future liver remnant hypertrophy was 93.2 %. Severe complications occurred in 44.4 % of patients and mortality occurred in two cases (22.2 %). Small for size syndrome occurred in two cases (22.2 %). The first one was detected intraoperatively during first stage. It was successfully managed by spleno-renal venous shunt. Second case was not promptly detected and died on postoperative day 64. This case series provides evidence that SFFS can be an important complication after ALPPS procedure. If it is not promptly detected and properly managed it can be a cause of death as occurred in our case.
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Acknowledgments
The authors would like to thank Pablo Ruiz, Isabel de Salas, Luka Mihic, and Benjamin Farber for their contribution.
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The authors declare that they have no conflict of interest.
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All procedures performed in studies involving human participants were in accordance with ethical standards of the institutional and/or nation research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standard.
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Vicente, E., Quijano, Y., Ielpo, B. et al. Is “small for size syndrome” a relatively new complication after the ALPPS procedure?. Updates Surg 67, 273–278 (2015). https://doi.org/10.1007/s13304-015-0300-9
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DOI: https://doi.org/10.1007/s13304-015-0300-9