Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS)—pushing the envelope in modulation of future liver remnant before major hepatectomy

Insufficient future liver remnant (FLR) is an important factor that precludes patient from upfront major liver resection as it predisposes to post-hepatectomy liver failure and mortality. As such, augmentation of FLR by portal vein embolization (PVE) was the conventional approach to improve the safety profile of major hepatectomy.