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The ALPPS Approach for the Management of Colorectal Carcinoma Liver Metastases

Authors
  • Alvarez, Fernando A.1
  • Ardiles, Victoria1
  • de Santibañes, Eduardo1,
  • 1 Hospital Italiano de Buenos Aires, General Surgery Service, Juan D. Perón 4190, Buenos Aires, C1181ACH, Argentina , Buenos Aires (Argentina)
Type
Published Article
Journal
Current Colorectal Cancer Reports
Publisher
Springer-Verlag
Publication Date
Feb 07, 2013
Volume
9
Issue
2
Pages
168–177
Identifiers
DOI: 10.1007/s11888-013-0159-4
Source
Springer Nature
Keywords
License
Yellow

Abstract

Liver resection is the treatment of choice for patients with colorectal liver metastases (CRLM). The possibility of achieving curative resection is limited by the future liver remnant (FLR), with posthepatectomy liver failure (PHLF) the most severe possible complication after major liver resection. Associated liver partition and portal vein ligation for staged hepatectomy (ALPPS) has recently been introduced as a strategy for prevention of PHLF by inducing a rapid and large FLR hypertrophy not achieved by other methods. To date, most of the evidence regarding ALPPS is based on retrospective analysis of small series of patients or of case reports. The promising short-term results obtained are difficult to interpret oncologically, because of the heterogeneous groups of patients with different underlying pathology, variable chemotherapy use, and technical variations applied. Only increased experience and long-term outcomes will better define the utility of this novel method.

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