Journal ArticleDOI
Right portal vein ligation combined with in situ splitting induces rapid left lateral liver lobe hypertrophy enabling 2-staged extended right hepatic resection in small-for-size settings.
Andreas A. Schnitzbauer,Sven A. Lang,H. Goessmann,Silvio Nadalin,Janine Baumgart,Stefan Farkas,Stefan Fichtner-Feigl,Thomas Lorf,Armin Goralcyk,Rüdiger Hörbelt,Alexander Kroemer,Martin Loss,Petra Rümmele,Marcus N. Scherer,Winfried Padberg,Alfred Königsrainer,Hauke Lang,Aiman Obed,Hans J. Schlitt +18 more
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TLDR
Two-step hepatic resection performing surgical exploration, PVL, and ISS results in a marked and rapid hypertrophy of functional liver tissue and enables curative resection of marginally resectable liver tumors or metastases in patients that might otherwise be regarded as palliative.Abstract:
Objective:To evaluate a new 2-step technique for obtaining adequate but short-term parenchymal hypertrophy in oncologic patients requiring extended right hepatic resection with limited functional reserve.Background:Patients presenting with primary or metastatic liver tumors often face the dilemma thread more
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Cholangiocarcinoma — evolving concepts and therapeutic strategies
TL;DR: Advances in comprehensive whole-exome and transcriptome sequencing have defined the genetic landscape of each cholangiocarcinoma subtype, and promising molecular targets for precision medicine have been identified, and are being evaluated in clinical trials, including those exploring immunotherapy.
Journal ArticleDOI
Right portal vein ligation combined with in situ splitting induces rapid left lateral liver lobe hypertrophy enabling 2-staged extended right hepatic resection in small-for-size settings.
TL;DR: This procedure may be able to overcome the shortcomings of “conventional” two-stage hepatectomy and result in an increased number of patients who could benefit from surgical treatment despite initially unresectable hepatic malignancies due to too small future liver remnant volume.
Journal ArticleDOI
Early survival and safety of ALPPS first report of the international ALPPS registry
Erik Schadde,Victoria Ardiles,Ricardo Robles-Campos,Massimo Malagó,Marcel Cerqueira César Machado,Roberto Hernandez-Alejandro,Olivier Soubrane,Andreas A. Schnitzbauer,Dimitri A. Raptis,Christoph Tschuor,Henrik Petrowsky,Eduardo de Santibañes,Pierre-Alain Clavien +12 more
TL;DR: This is the first analysis of the ALPPS registry showing that ALPPS has increased perioperative morbidity and mortality in older patients but better outcomes in patients with CRLM.
Journal ArticleDOI
Playing Play-Doh to prevent postoperative liver failure: the "ALPPS" approach.
TL;DR: The development of the various types of staged hepatectomies is shown, representing one of the most promising advances in oncological liver surgery so far.
Journal ArticleDOI
ALPPS Offers a Better Chance of Complete Resection in Patients with Primarily Unresectable Liver Tumors Compared with Conventional-Staged Hepatectomies: Results of a Multicenter Analysis
Erik Schadde,Victoria Ardiles,Ksenija Slankamenac,Christoph Tschuor,Gregory Sergeant,Nadja Amacker,J. Baumgart,Kris P. Croome,Roberto Hernandez-Alejandro,Hauke Lang,Eduardo de Santibaňes,Pierre-Alain Clavien +11 more
TL;DR: Evidence is provided that ALPPS offers a better chance of complete resection in patients with primarily unresectable liver tumors at the cost of a high mortality, which should currently not be used outside of studies and registries.
References
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Journal ArticleDOI
Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey.
TL;DR: The new complication classification appears reliable and may represent a compelling tool for quality assessment in surgery in all parts of the world.
Journal ArticleDOI
Seven hundred forty-seven hepatectomies in the 1990s: an update to evaluate the actual risk of liver resection.
Jacques Belghiti,Kazuhiro Hiramatsu,Stéphane Benoist,Pierre Philippe Massault,Alain Sauvanet,Olivier Farges +5 more
TL;DR: In this paper, a multivariate analysis of the risk factors for postoperative mortality, morbidity, and transfusion after stratifying patients for the circumstance of the operation and the pathological changes of the remnant liver was performed.
Journal ArticleDOI
Portal vein embolization before right hepatectomy: prospective clinical trial.
Olivier Farges,Jacques Belghiti,Reza Kianmanesh,Jean-Marc Regimbeau,Roberto Santoro,Valérie Vilgrain,Alban Denys,Alain Sauvanet +7 more
TL;DR: Before elective right hepatectomy, the hypertrophy of FLR induced by PVE had no beneficial effect on the postoperative course in patients with normal liver, and before chronic liver disease, PVE significantly decreased the incidence of postoperative complications as well as the intensive care unit stay and total hospital stay.
Journal ArticleDOI
Preoperative portal vein embolization for major liver resection: a meta-analysis.
Adel Abulkhir,Paolo Limongelli,Andrew J. Healey,O. Damrah,Paul Tait,James C. Jackson,Nagy A. Habib,Long R. Jiao +7 more
TL;DR: PVE is a safe and effective procedure in inducing liver hypertrophy to prevent postresection liver failure due to insufficient liver remnant and the rate for minor complications was significantly higher among patients who had PTPE than TIPE group.
Journal ArticleDOI
Hepatic Insufficiency and Mortality in 1,059 Noncirrhotic Patients Undergoing Major Hepatectomy
John T. Mullen,Dario Ribero,Srinevas K. Reddy,Matteo Donadon,Daria Zorzi,Shiva Gautam,Eddie K. Abdalla,Steven A. Curley,Lorenzo Capussotti,Bryan M. Clary,Jean Nicolas Vauthey +10 more
TL;DR: PHI defined as (Peak)Bil > 7.0 mg/dL accurately predicts liver-related death and worse outcomes after major hepatectomy and was the most powerful predictor of any major complication.
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Playing Play-Doh to prevent postoperative liver failure: the "ALPPS" approach.
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