title: Modified Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy for Hepatoblastoma in a Small Infant: How Far Can We Push the Envelope?
abstract: : For patients with hepatoblastoma, a timely and complete resection of the tumor is critical to the patient's tumor recurrence-free survival. Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS), a 2-stage hepatectomy procedure, has revolutionized the surgical management of large hepatic tumors with insufficient future liver remnant (FLR) at presentation. Although existing data support the utility of ALPPS in adults with primary and metastatic hepatobiliary malignancy, the literature in children is scarce. To our knowledge, this is the first report showing clinical applicability and safety of the modified ALPPS procedure in a small infant (54 days old) with hepatoblastoma who presented with insufficient FLR. Our report suggests the modified ALPPS could potentially expand the surgical treatment alternative for small infants with large hepatoblastoma.
authors.affiliation: *Division of Transplant Surgery, Medical College of Wisconsin and Children's Hospital of Wisconsin, Milwaukee, WI †Division of Hematology, Oncology, Bone Marrow Transplant, Medical College of Wisconsin and Children's Hospital of Wisconsin, Milwaukee, WI ‡Division of Pediatric Surgery, Medical College of Wisconsin and Children's Hospital of Wisconsin, Milwaukee, WI §Division of Gastroenterology and Hepatology, Medical College of Wisconsin and Children's Hospital of Wisconsin, Milwaukee, WI ¶Division of Pediatric Pathology, Medical College of Wisconsin and Children's Hospital of Wisconsin, Milwaukee, WI.
authors.forename: Johnny C
authors.initials: JC
authors.lastname: Hong
authors.forename: Joohyun
authors.initials: J
authors.lastname: Kim
authors.forename: Meghen
authors.initials: M
authors.lastname: Browning
authors.forename: Amy
authors.initials: A
authors.lastname: Wagner
authors.forename: Stacee
authors.initials: S
authors.lastname: Lerret
authors.forename: Annette D
authors.initials: AD
authors.lastname: Segura
authors.forename: Michael A
authors.initials: MA
authors.lastname: Zimmerman
mesh_terms: D006498:Hepatectomy / Q000379:methods*; D018197:Hepatoblastoma / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008026:Ligation / Q000379:methods; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D011169:Portal Vein / Q000601:surgery*; D016896:Treatment Outcome