Using ALPPS to Induce Rapid Liver Hypertrophy in a Patient with Hepatic Fibrosis and Portal Vein Thrombosis
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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...
KeywordsPortal Vein Portal Vein Thrombosis Portal Vein Embolization Tumor Thrombus Future Liver Remnant
Dr. William C. Chapman is acknowledged as a cofounder of Pathfinder Therapeutics, Inc.
- 3.Earl TM, Chapman WC. Conventional Surgical Treatment of Hepatocellular Carcinoma. Clin Liver Dis 2011;15:353–70, vii-x.Google Scholar