Abstract
Introduction - Aim
Colorectal carcinoma (CRC) is the third most common cancer in the Western world. Radical resection of liver metastases remains the only curative option. Postoperative liver failure has become the main concern because of insufficient future liver remnant (FLR). Several techniques have evolved to induce liver hypertrophy of the FLR prior to hepatectomy in primarily unresectable liver tumours. An innovative two-staged technique named as associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has shown promising results. Herein, we report the first case of ALPPS in the Greek population ever to be reported, and also provide a review of the current literature regarding this novel surgical procedure.
Method
A 70-year-old male presented with a history of altered bowel habits and haematochezia. Colonoscopy revealed a sigmoid adenocarcinoma. Computed tomography (CT) disclosed bilobar liver metastases. The initial decision of the multidisciplinary team was to use upfront chemotherapy. Magnetic resonance imaging (MRI) and CT of the abdomen showed minimal response after completion of the chemotherapy regimen. A right trisectionectomy via the ALPPS procedure and a simultaneous left hemicolectomy were performed. A systematic literature search was conducted with regard to other cases of ALPPS.
Results
The patient’s postoperative course was complicated by post hepatectomy Grade A liver failure, according to the International Study Group of Liver Surgery definition.
Conclusions
ALPPS is a novel innovative procedure that has generated great enthusiasm in the field of hepatobiliary surgery. Indications for ALPPS should be re-evaluated and a common consensus reached among centres for a standardized surgical technique.
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Papalampros, A., Vailas, M.G., Felekouras, E. et al. Associating liver partition and portal vein ligation for staged hepatectomy: An emerging paradigm? Literature review apropos of the first case in Greece. Hellenic J Surg 88, 186–192 (2016). https://doi.org/10.1007/s13126-016-0313-y
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DOI: https://doi.org/10.1007/s13126-016-0313-y