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Full robotic ALPPS for HCC with intrahepatic portal vein thrombosis
Author(s) -
Di Benedetto Fabrizio,
Assirati Giacomo,
Magistri Paolo
Publication year - 2020
Publication title -
the international journal of medical robotics and computer assisted surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.556
H-Index - 53
eISSN - 1478-596X
pISSN - 1478-5951
DOI - 10.1002/rcs.2087
Subject(s) - medicine , hepatocellular carcinoma , hepatectomy , portal vein thrombosis , portal vein , surgery , thrombus , robotic surgery , radiology , resection
Background The associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) technique can induce a greater degree of hypertrophy of the future liver remnant (FLR) in a shorter time compared with other procedures. A robotic approach may reduce the complication rate, increasing the ability to perform classic ALPPS. Methods We report technical and clinical considerations on the first full robotic ALPPS (stages 1 and 2) for hepatocellular carcinoma (HCC) with portal vein intrahepatic tumor thrombus. Results The patient was a 38‐year‐old man with Milan‐out HCC and FLR volume of 19.6%. On postoperative day (POD) 8, FLR increased to 37%; therefore, he underwent completion of ALPPS on POD 10. The postoperative course was uneventful, and the patient was discharged in good general conditions on POD 3. Conclusion Robotic ALPPS is safe and feasible for selected patients with initially unresectable HCC or requiring extended resections, with good postoperative outcomes.