Greater hypertrophy can be achieved with associating liver partition with portal vein ligation for staged hepatectomy compared to conventional staged hepatectomy, but with a higher price to pay?
Am J Surg
; 215(1): 131-137, 2018 Jan.
Article
em En
| MEDLINE
| ID: mdl-28859921
ABSTRACT
BACKGROUND:
Associating 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).METHODS:
A retrospective comparison of clinical data, liver volumetry and surgical outcomes between 10 ALPPS and 29 CSH patients was performed.RESULTS:
Patient 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.CONCLUSION:
ALPPS was superior in inducing FLR growth but associated with increased post-hepatectomy liver failure compared to CSH.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Veia Porta
/
Carcinoma Hepatocelular
/
Hepatectomia
/
Neoplasias Hepáticas
/
Regeneração Hepática
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article