• Daryl K A Chia, Zachery Yeo, Stanley E K Loh, Shridhar Ganpathi Iyer, Bonney Glenn Kunnath GK Division of Hepatopancreaticobiliary Surgery and Liver Transplantation, Department of Surgery, National University Health System, Singapore., Krishnakumar Madhavan, and Alfred W C Kow.
• Division of Hepatopancreaticobiliary Surgery and Liver Transplantation, Department of Surgery, National University Health System, Singapore.
• Am. J. Surg. 2018 Jan 1; 215 (1): 131-137.

BackgroundAssociating liver partition with portal vein ligation for staged hepatectomy (ALPPS) and conventional staged hepatectomy (CSH) are options for patients with unresectable liver tumors due to insufficient future liver remnant (FLR).MethodsA retrospective comparison of clinical data, liver volumetry and surgical outcomes between 10 ALPPS and 29 CSH patients was performed.ResultsPatient demographics and disease characteristics were similar between both groups. ALPPS induced superior FLR growth (ALPPS vs. CSH, 48.1% (IQR 39.4-96.9%) vs. 11.8% (IQR 4.3-41.9%), p = 0.013). However, post-operative day 5 international normalized ratio (INR) (ALPPS vs. CSH, 1.6 (IQR 1.5-1.8) vs. 1.4 (IQR 1.3-1.6), p = 0.015) and rate of post-hepatectomy liver failure (ALPPS vs. CSH, 25 vs. 0%, p = 0.032) was higher in the ALPPS group. 90-day mortality (ALPPS vs. CSH, 12.5% vs. 0%, p = 0.320) was similar in both groups.ConclusionALPPS was superior in inducing FLR growth but associated with increased post-hepatectomy liver failure compared to CSH.Copyright © 2017 Elsevier Inc. All rights reserved.

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