| International Session (Symposium) 7 (JSGS・JSGE・JSH) |
| Sat. November 3rd 14:00 - 17:00 Room 4: Portopia Hotel South Wing Portopia Hall |
| Strategy to overcome insufficient future liver remnant -our experience of ALPPS- | |||
| Nozomu Sakai1, Masayuki Ohtsuka1 | |||
| 1Department of General Surgery, Chiba University | |||
|
|||
|
|||
| Aim: To evaluate the impact of ALPPS on changes of future liver remnant volume (FLR) and short to mid-term outcome after hepatic resection for advanced multiple/huge liver tumors. Patients: From 2004 to 2017, ALPPS was applied to 7 patients who had insufficient FLR or liver dysfunction to complete curative resection of primary or metastatic liver tumors. Results: Median age was 68 years old. Five patients were male and 2 was female. Diagnoses were colorectal liver metastases (CRLM) in 5 cases, hepatocellular carcinoma (HCC) in 1 case and neuroendocrine tumor in 1 case. Complete resection by the second stage operation was achieved in 6 cases. One case with HCC failed to achieve the second stage due to poor performance status. ALPPS was applied as a salvage in patients with insufficient FLR after portal vein embolization (PVE) in 2 cases (i.e. rescue ALPPS). Median value of ICG R15 except a HCC case was 14.4%. Interval from stage I to stage II was 14 days. FLR at initial CT volumetry was 29.2%. Volume increase of FLR after stage I per day was 30.8 ml/day and FLR reached to 48.8%. Postoperative mortality was zero in all patients. MST was 14 months after ALPPS. Recurrences were found in all patients with CRLM. Conclusion: ALPPS can be a strong option to improve resectability of advanced liver tumor even in the case with liver dysfunction or insufficient FLR after PVE. Prognostic impact of ALPPS remains unclear and needs to be determined with prospective studies. |
|||
|
Index Term 1: colorectal liver metastases Index Term 2: ALPPS |
|||
| Page Top | |||