Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy

Abstract

Objectives: To study the safety and efficacy of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) for HCC patients. Methods: The clinic datas of 6 HCC patients who underwent associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) from October 2013 to July 2014 was analyzed respectively. Operative process can be divided into two steps, the first operation is liver split and portal vein ligation with the conventional methods, then second operation will be done at least 2 weeks after first operation and the remaining volume of liver is greater than 40%, the liver that need resected wil be moved out. Surgical techniques and treatment response were retrospectively reviewed. 4 male and 2 Famle of patients and aging from 28 to 66 years with a mean of (49.5 +/- 13.9) years. 4 of the 6 patients were infected with hepatitis B virus and had liver cirrhosis. Residual liver volume ratio after first hepatic resection less than 30%. Results: The first surgical time and second surgical time was 195-385 min and 210-485 min, with a mean of 297.7 +/- 67.7 min and 331.2 +/- 100.8 min respectively. The bleeding in first surgical and second surgical was 200-600 mL and 100-1200 mL, with a mean of 376.7 +/- 141.7 mL and 683.3 +/- 444.6 mL respectively. The hospital stay was 32-77 days, with a mean of (55.2 +/- 18.6) days. 4 medical complications and no postoperative death happend. 5 patients were cured and discharged, 1 patient still in the hospital. Conclusion: Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) for HCC patientgs is safe and effective.