Retrospect and prospect of associating liver partition and portal vein ligation for staged hepatectomy

Abstract

Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is introduced as a modified two staged hepatectomy for advanced liver malignancies, which requires extended hepatectomy with very small future remnant liver volume. It is characterized by rapid and large growth of future remnant liver and potential of widening the indication of curative resection with extended major hepatectomy for liver malignancies. However, it showed much higher morbidity of complications and mortality than extended hepatectomy after portal vein embolization. The development of ALPPS is often controversial. In this article, the development and pro-blems of ALPPS are retrospected and summarized, in order to reflect the role of ALPPS in Japan where zero mortality after hepatectomy is highly expected. Key words: Liver neoplasms; Associating liver partition and portal vein ligation for staged hepatectomy; Liver regeneration; Portal vein embolization