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131. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

25.03. - 28.03.2014, Berlin

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Is tumor infiltration to the right portal vein a contraindication for ALPPS?

Meeting Abstract

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  • Jun Li - Universitätsklinikum Hamburg-Eppendorf, Klinik für Hepatobiliäre Chirurgie und Transplantationschirurgie, Hamburg
  • Alexandros Kantas - Universitätsklinikum Hamburg-Eppendorf, Klinik für Hepatobiliäre Chirurgie und Transplantationschirurgie, Hamburg
  • Harald Ittrich - Universitätsklinikum Hamburg-Eppendorf, Klinik für Hepatobiliäre Chirurgie und Transplantationschirurgie, Hamburg
  • Lutz Fischer - Universitätsklinikum Hamburg-Eppendorf, Klinik für Hepatobiliäre Chirurgie und Transplantationschirurgie, Hamburg
  • Björn Nashan - Universitätsklinikum Hamburg-Eppendorf, Klinik für Hepatobiliäre Chirurgie und Transplantationschirurgie, Hamburg

Deutsche Gesellschaft für Chirurgie. 131. Kongress der Deutschen Gesellschaft für Chirurgie. Berlin, 25.-28.03.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. Doc14dgch202

doi: 10.3205/14dgch202, urn:nbn:de:0183-14dgch2024

Published: March 21, 2014

© 2014 Li et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Introduction: Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has been successfully applied to increase the future liver remnant before a right trisectionectomy. Tumor infiltration to the right portal vein is a challenge situation.

Material and methods: A patient with advanced gallbladder carcinoma underwent exploration. Intraoperative finding showed tumor infiltration of the right portal vein and the duodenum. In-situ split of the left lateral liver lobe combined with postoperative right portal vein embolization completed the concept of ALPPS.

Results: Successful right trisectionectomy in combination with whipple operation without tumor residual could be achieved 8 days later, while the liver remnant increased from 491 ml to 911 ml. Neither post-hepatectomy liver failure nor postoperative anastomotic leak has been observed. 3 month follow up has not shown any sign of tumor recurrence.

Conclusion: In-situ split combined with postoperative right portal vein embolization provided a good solution for ALPPS to solve the problem of tumor infiltration of the right portal vein.