Document Detail


Associating liver partition and portal vein ligation for a patient with hepatocellular carcinoma with a background of hepatitis B related fibrotic liver.
MedLine Citation:
PMID:  25460479     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
INTRODUCTION: Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has recently been developed for patients with predicted insufficient future liver remnant volumes to induce more rapid hepatic hypertrophy and increase resectability. In the medical literature, the use of ALPPS in hepatocellular carcinoma (HCC) has rarely been reported.
PRESENTATION OF CASE: We reported the use of ALPPS in a patient with primarily unresectable HCC arising from a background of hepatitis B related liver fibrosis. Preoperative computed tomography (CT) showed 2 large conglomerated tumors measuring 16cm×10.5cm in liver segments 5, 6, 7 and 8, and at least 3 satellite nodules with the largest one measuring 3cm around the main tumor and another 4cm tumor in segment 4. Right trisectionectomy after ALPPS was successfully performed. He was discharged from hospital on postoperative day 13 after the second operation. Follow-up CT scan at 6 weeks after the second operation showed further hypertrophy of the liver remnant and no liver recurrence.
DISCUSSION: Our case showed that this novel strategy is feasible even in the context of a background of chronic hepatitis B related liver fibrosis, although the hypertrophy rate was a little bit slower and the time needed was longer.
CONCLUSION: ALPPS is also feasible in liver fibrosis. It gives hope to patients with HCC who previously were considered as having unresectable diseases. More studies are needed to further evaluate the effectiveness and oncological outcomes of ALPPS from these patients.
Authors:
Nam Hung Chia; Eric C H Lai; Wan Yee Lau
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-11-8
Journal Detail:
Title:  International journal of surgery case reports     Volume:  5     ISSN:  2210-2612     ISO Abbreviation:  Int J Surg Case Rep     Publication Date:  2014 Nov 
Date Detail:
Created Date:  2014-12-2     Completed Date:  -     Revised Date:  2014-12-3    
Medline Journal Info:
Nlm Unique ID:  101529872     Medline TA:  Int J Surg Case Rep     Country:  -    
Other Details:
Languages:  ENG     Pagination:  1077-1081     Citation Subset:  -    
Copyright Information:
Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.
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