title: Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) procedure for hepatocellular carcinoma with chronic liver disease: a case report and review of literature.
abstract: The incidence of complications after liver resection is closely related to functional future liver remnant (FLR). The standard approach to augment FLR is surgical or radiological occlusion of the artery or portal vein on the tumor side. Associated liver partition and portal vein ligation for staged hepatectomy (ALLPS) has been introduced as an alternative method to augment FLR. It offers rapid and effective hypertrophy for resecting liver metastases. However, data regarding its application in patients with hepatocellular carcinoma (HCC) with a background of chronic liver disease are limited. Here we describe the use of ALPPS procedure to manage a large solitary HCC with a background of chronic liver disease. The rising incidence of HCC has increased the number of surgical resections in patients with advanced stage liver disease not considered for liver transplantation. We reviewed reported experience of ALPPS in established chronic liver disease and current therapeutic modalities for HCC on a background of chronic liver disease in patients with potential liver insufficiency where tumor burden is beyond liver transplant criteria.
authors.affiliation: Institute of Liver Studies, Kings Health Partners of King's College Hospital, NHS Foundation Trust, London, United Kingdom.
authors.forename: Michail
authors.initials: M
authors.lastname: Papamichail
authors.affiliation: Institute of Liver Studies, Kings Health Partners of King's College Hospital, NHS Foundation Trust, London, United Kingdom.
authors.forename: Michail
authors.initials: M
authors.lastname: Pizanias
authors.affiliation: Institute of Liver Studies, Kings Health Partners of King's College Hospital, NHS Foundation Trust, London, United Kingdom.
authors.forename: Vincent
authors.initials: V
authors.lastname: Yip
authors.affiliation: Institute of Liver Studies, Kings Health Partners of King's College Hospital, NHS Foundation Trust, London, United Kingdom.
authors.forename: Evangellos
authors.initials: E
authors.lastname: Prassas
authors.affiliation: Institute of Liver Studies, Kings Health Partners of King's College Hospital, NHS Foundation Trust, London, United Kingdom.
authors.forename: Andreas
authors.initials: A
authors.lastname: Prachalias
authors.affiliation: Institute of Liver Studies, Kings Health Partners of King's College Hospital, NHS Foundation Trust, London, United Kingdom.
authors.forename: Alberto
authors.initials: A
authors.lastname: Quaglia
authors.affiliation: Institute of Liver Studies, Kings Health Partners of King's College Hospital, NHS Foundation Trust, London, United Kingdom.
authors.forename: Praveen
authors.initials: P
authors.lastname: Peddu
authors.affiliation: Institute of Liver Studies, Kings Health Partners of King's College Hospital, NHS Foundation Trust, London, United Kingdom.
authors.forename: Nigel
authors.initials: N
authors.lastname: Heaton
authors.affiliation: Institute of Liver Studies, Kings Health Partners of King's College Hospital, NHS Foundation Trust, London, United Kingdom.
authors.forename: Parthi
authors.initials: P
authors.lastname: Srinivasan
keywords: ALPPS; Liver cirrhosis