Abdominal cross-sectional imaging of the associating liver partition and portal vein ligation for staged hepatectomy procedure

Table 3 Overview of normal and abnormal findings after surgical stages 1 and 2

	Normal findings		Abnormal findings
Postoperative phase	Goals of ALPPS	Findings not to be confused with pathological aspects	prompting intervention
After surgical stage 1	Hypertrophic FLR (≥ 40% of baseline preoperative volume)	Thin rim of free fluid around both FLR and DH	Large, persisting collections (hematoma, bilomas, infected collections)
		Air bubbles within the perihepatic fluid, especially on the hepatectomy line	Bleeding
			Biliary dilation
		Mild periportal edema	Bile leakage/fistula
		Hypertrophy of hepatic artery for the DH	Portal vein thrombosis
After surgical stage 2	Uncomplicated appearance of the FLR (e.g., no relapsing focal liver lesions)	Thin rim of free fluid around FLR	Early complications
		Air bubbles	see surgical stage 1
		Hypoattenuating linear band adjacent to liver raw surface	Late complications (3-6 mo)
			Biliary stricture
		Rotation of hypertrophic FLR	Biliary fistula
		Transitory splenomegaly	Tumor recurrence

ALPPS: Associated liver partition and portal vein ligation for staged hepatectomy; FLR: Future liver remnant; DH: Diseased hemiliver.