Document Detail

ALPPS in Right Trisectionectomy: a Safe Procedure to Avoid Postoperative Liver Failure?
MedLine Citation:
PMID:  23288719     Owner:  NLM     Status:  Publisher    
INTRODUCTION: To induce rapid hepatic hypertrophy and to reduce post-hepatectomy liver failure (PHLF), associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has been recently developed for patients with a limited future liver remnant. The aim of this study was to further assess the perioperative risk of this procedure and its specific indications. PATIENTS AND METHODS: The study was performed between November 2010 and April 2012 for patients undergoing right trisectionectomy by the ALPPS approach. Liver volume, intra- and postoperative complications, including PHLF, and residual tumour status were compared for patients with different diagnoses. RESULTS: The interval between two operations in nine patients undergoing ALPPS was 13 days (median). Sufficient hepatic hypertrophy was achieved with a volume gain of 87.2 % (median). All patients underwent right trisectionectomy without residual tumours. In contrast to six patients with uneventful intra- and postoperative course, bile leak, vancomycin-resistant enterococcus infection, PHLF and sepsis developed in two of three patients with hilar cholangiocarcinoma as the preoperative diagnosis. CONCLUSION: ALPPS leads to sufficient hepatic hypertrophy within 2 weeks, avoiding PHLF in most patients. In patients with hilar cholangiocarcinoma, ALPPS should be applied with extreme caution due to high morbidity and mortality.
Jun Li; Paolo Girotti; Ingmar Königsrainer; Ruth Ladurner; Alfred Königsrainer; Silvio Nadalin
Related Documents :
16012039 - Surgical treatment of pharyngostomes in irradiated patients. our experience with muscul...
24803979 - Gallbladder agenesis with a primary choledochal stone in a patient with situs inversus ...
20396379 - Use of gastrointestinal anastomosis stapler for harvest of gracilis muscle and securing...
3968949 - Immediate reconstruction after total laryngopharyngoesophagectomy and mediastinal disse...
23912009 - Multiple pyogenic liver abscesses with the decline in neutrophil phagocytic function: a...
7354639 - Complications associated with covering the bronchial stump with pleura.
3178099 - Thyroglossal duct remnants in infants and children: reevaluation of histopathology and ...
12662229 - How should gynaecomastia be managed?
19610149 - Right trisegmentectomy with thoracoabdominal approach after transarterial embolization ...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-4
Journal Detail:
Title:  Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract     Volume:  -     ISSN:  1873-4626     ISO Abbreviation:  J. Gastrointest. Surg.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9706084     Medline TA:  J Gastrointest Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
General, Visceral and Transplantation Surgery, University Hospital Tuebingen, Hoppe-Seyler-Str. 3, 72076, Tuebingen, Germany,
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Laparoscopic Gastric Electrical Stimulation for Medically Refractory Diabetic and Idiopathic Gastrop...
Next Document:  Alterations in Wnt/?-catenin and Pten signaling play distinct roles in endometrial cancer initiation...