Modulated partial associating liver partition and portal vein ligation for staged hepatectomy for colorectal liver disease: a case report

Abstract

Postoperative liver failure remains one of the most common causes of mortality after liver surgery. Many techniques have been developed to induce parenchymal increase to reduce the incidence of postoperative liver failure. In our video [online] we showed our technique, which we called “modulated partial associating liver partition and portal vein ligation for staged hepatectomy (ALPPS),” which aimed to minimize the surgical stress between the two phases of a two-stage hepatectomy. Our patient was a 49-year-old man affected by colorectal liver metastases who underwent a two-stage right hepatectomy through the modulated partial ALPPS technique. Postoperative CT scans revealed an increase in future liver remnants, that resulted sufficient for the patient to sustain liver resection. Although further studies would be necessary and true randomization is hard to obtain, in relation to the complexity of these cases, we propose a feasible technique that reduces the surgical stress between the two phases of a two-stage hepatectomy, improving the prognosis for patients affected by colorectal liver metastases.