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Role of associating liver partition and portal vein ligation for staged hepatectomy in colorectal liver metastases: A review
Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping.
Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping. Linköping University, Faculty of Medicine and Health Sciences.
Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping. Linköping University, Faculty of Medicine and Health Sciences.
2015 (English)In: World Journal of Gastroenterology, ISSN 1007-9327, E-ISSN 2219-2840, Vol. 21, no 15, 4491-4498 p.Article, review/survey (Refereed) Published
Abstract [en]

Colorectal cancer is the third most common cancer in the Western world. Approximately half of patients will develop liver metastases, which is the most common cause of death. The only potentially curative treatment is surgical resection. However, many patients retain a to small future liver remnant (FLR) to allow for resection directly. There are therefore strategies to decrease the tumor with neoadjuvant chemotherapy and to increase the FLR. An accepted strategy to increase the FLR is portal vein occlusion (PVO). A concern with this strategy is that a large proportion of patients will never be operated because of progression during the interval between PVO and resection. ALPPS (associating liver partition and portal vein ligation for staged hepatectomy) is a new procedure with a high resection rate. A concern with this approach is the rather high frequency of complications and high mortality, compared to PVO. In this review, it is shown that with ALPPS the resection rate was 97.1% for CRLM and the mortality rate for all diagnoses was 9.6%. The mortality rate was likely lower for patients with CRLM, but some data were lacking in the reports. Due to the novelty of ALPPS, the indications and technique are not yet established but there are arguments for ALPPS in the context of CRLM and a small FLR.

Place, publisher, year, edition, pages
Baishideng Publishing Group Co. Limited , 2015. Vol. 21, no 15, 4491-4498 p.
Keyword [en]
Colorectal liver metastases; Associating liver partition and portal vein ligation for staged hepatectomy; Portal vein embolization; Neoadjuvant chemotherapy; Liver surgery
National Category
Clinical Medicine
Identifiers
URN: urn:nbn:se:liu:diva-118048DOI: 10.3748/wjg.v21.i15.4491ISI: 000353302100007PubMedID: 25914457OAI: oai:DiVA.org:liu-118048DiVA: diva2:812992
Available from: 2015-05-21 Created: 2015-05-20 Last updated: 2016-03-31

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Hasselgren, KristinaSandström, PerBjörnsson, Bergthor
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Division of Clinical SciencesFaculty of Medicine and Health SciencesDepartment of Surgery in Linköping
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