A case presentation of ALPPS procedure for liver resection

Abstract

In patient with colorectal liver metastases only surgery is associated with a survival plateau. Main factors for resection are localizations of metastasis and functional liver remnant. To prevent liver failure after extended hepatic resection we perform two stage procedure with portal vein ligation or embolisation. In March 2012 was published first large study for new technique of two stage hepatic resection. In fisrt procedure surgeon performed in situ resection with perservation of arteries, vein and bile ducts. After one week CT was performed and if adequate hypertrophy of liver remain was observed final procedure with removal of transected liver was performed. Authors describe 100% hypertrophy of future liver remant in 1 to 2 week period. We will describe first procedure performed in Slovenia in our clinical department.