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Future liver remnant portal or hepatic vein reconstruction at stage I of ALPPS—How far can we push the boundaries?
Author(s) -
Schlegel Andrea,
Sakuraoka Yuhki,
Kalisvaart Marit,
Coldham Chris,
Isaac John,
Muiesan Paolo
Publication year - 2019
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.25618
Subject(s) - medicine , hepatectomy , portal vein embolization , portal vein , ligation , vein , stage (stratigraphy) , surgery , embolization , parenchyma , hepatic veins , radiology , resection , pathology , paleontology , biology
Abstract Preservation of the future liver remnant (FLR) vascular integrity has always been considered crucial to achieving successful liver growths after major hepatectomies. Most surgeons appeared therefore reluctant to combine stage I of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) with vascular reconstructions. Here we describe a case series, where we combine parenchymal transection and venous in‐ or outflow reconstruction of the FLR at stage I of ALPPS. In addition, the cold flush of the FLR or delayed portal vein embolization is applied in selected cases.