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Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Feb 27, 2016; 8(2): 124-133
Published online Feb 27, 2016. doi: 10.4240/wjgs.v8.i2.124
Associating liver partition and portal vein ligation for staged hepatectomy: From technical evolution to oncological benefit
Jun Li, Florian Ewald, Amit Gulati, Björn Nashan
Jun Li, Florian Ewald, Björn Nashan, Department of Hepatobiliary and Transplant Surgery, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
Amit Gulati, Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
Author contributions: Li J design of the study, literature review and analysis, drafted and wrote the final version of the manuscript; Ewald F literature review, drafted and wrote the final version of the manuscript; Gulati A literature review, drafted and wrote the final version of the manuscript; Nashan B design of the study, critical revision, edited and final approval of the final version
Conflict-of-interest statement: The authors declare no conflicts of interest regarding this manuscript.
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/
Correspondence to: Jun Li, MD, Department of Hepatobiliary and Transplant Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany. j.li@uke.de
Telephone: +49-40-741058572 Fax: +49-40-741045001
Received: August 7, 2015
Peer-review started: August 10, 2015
First decision: September 18, 2015
Revised: October 8, 2015
Accepted: December 9, 2015
Article in press: December 11, 2015
Published online: February 27, 2016
Abstract

Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is a novel approach in liver surgery that allows for extensive resection of liver parenchyma by inducing a rapid hypertrophy of the future remnant liver. However, recent reports indicate that not all patients eligible for ALPPS will benefit from this procedure. Therefore, careful patient selection will be necessary to fully exploit possible benefits of ALPPS. Here, we provide a comprehensive overview of the technical evolution of ALPPS with a special emphasis on safety and oncologic efficacy. Furthermore, we review the contemporary literature regarding indication and benefits, but also limitations of ALPPS.

Keywords: Liver tumor, Resection, Hepatectomy, Staged, Portal vein embolization, Future liver remnant, Liver hypertrophy, Liver failure, Morbidity, Mortality

Core tip: We provide a comprehensive overview of the technical evolution of Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) with a special emphasis on safety and oncologic efficacy. Furthermore, we review the contemporary literature regarding indication and benefits, but also limitations of ALPPS.