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World J Gastroenterol. Nov 21, 2019; 25(43): 6373-6385
Published online Nov 21, 2019. doi: 10.3748/wjg.v25.i43.6373
Current status of associating liver partition with portal vein ligation for staged hepatectomy: Comparison with two-stage hepatectomy and strategies for better outcomes
Kin Pan Au, Albert Chi Yan Chan
Kin Pan Au, Department of Surgery, Queen Mary Hospital, Hong Kong, China
Albert Chi Yan Chan, Department of Surgery and State Key Laboratory for Liver Research, The University of Hong Kong, Hong Kong, China
Author contributions: Au KP did the literature review and wrote the manuscript; Chan ACY supervised the study and made revision to the manuscript; Both authors approved the submitted version of the manuscript.
Conflict-of-interest statement: The authors have no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Albert Chi Yan Chan, FRCS (Ed), Associate Professor, Department of Surgery, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, China. acchan@hku.hk
Telephone: +86-852-22553025
Received: May 27, 2019
Peer-review started: May 27, 2019
First decision: July 21, 2019
Revised: July 31, 2019
Accepted: August 7, 2019
Article in press: August 7, 2019
Published online: November 21, 2019
Processing time: 178 Days and 17.3 Hours
Core Tip

Core tip: Associating liver partition with portal vein ligation for staged hepatectomy (ALPPS) is associated with high morbidity and mortality. Operative mortality is usually a result of post-hepatectomy liver failure. Young patients with colorectal liver metastasis are ideal candidates. ALPPS for cholangiocarcinoma is associated with fair outcomes. In patients with challenging anatomy, partial ALPPS reduces morbidity, but remnant hypertrophy may compare unfavorably to a complete split. When compared to conventional two-stage hepatectomy with portal vein embolization or portal vein ligation, ALPPS has a higher resection rate. However, the long-term outcomes are yet to be determined.