Journal of Gastrointestinal Surgery

, Volume 17, Issue 1, pp 207–212 | Cite as

Using ALPPS to Induce Rapid Liver Hypertrophy in a Patient with Hepatic Fibrosis and Portal Vein Thrombosis

  • Keith M. Cavaness
  • M. B. Majella Doyle
  • Yiing Lin
  • Erin Maynard
  • William C. Chapman
Case Report


Large or critically located hepatic tumors continue to be a challenge for surgeons as they push to obtain adequate surgical margins and often leave less residual liver behind. While it has been shown that up to 80 % of a healthy liver can be resected, additional challenges exist with the “less than healthy liver” when planning an operative procedure and determining the future liver remnant (FLR) volume. The main goal is to obtain adequate margins while avoiding postoperative liver decompensation and failure. Postoperative liver failure (PLF) has been reported to have a mortality rate as high as 32 % and is often associated with sepsis and multisystem organ failure.1

It has been shown that patients without liver disease (normal background liver) can recover with an FLR volume of greater than or equal to 25 % without significant postoperative sequelae.2However, as we progress down the pathway of liver dysfunction, patients with chronic liver disease but without cirrhosis...


Portal Vein Portal Vein Thrombosis Portal Vein Embolization Tumor Thrombus Future Liver Remnant 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Dr. William C. Chapman is acknowledged as a cofounder of Pathfinder Therapeutics, Inc.


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Copyright information

© The Society for Surgery of the Alimentary Tract 2012

Authors and Affiliations

  • Keith M. Cavaness
    • 1
  • M. B. Majella Doyle
    • 1
  • Yiing Lin
    • 1
  • Erin Maynard
    • 1
  • William C. Chapman
    • 1
    • 2
  1. 1.Department of Surgery, Section of Abdominal TransplantationWashington University School of MedicineSt. LouisUSA
  2. 2.One Barnes-Jewish Hospital PlazaSt. LouisUSA

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