Editorial
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 21, 2017; 23(23): 4140-4145
Published online Jun 21, 2017. doi: 10.3748/wjg.v23.i23.4140
Evolution of associating liver partition and portal vein ligation for staged hepatectomy: Simpler, safer and equally effective methods
Shu-You Peng, Xu-An Wang, Cong-Yun Huang, You-Yong Zhang, Jiang-Tao Li, De-Fei Hong, Xiu-Jun Cai
Shu-You Peng, Jiang-Tao Li, Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China
Xu-An Wang, Department of General Surgery, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
Cong-Yun Huang, Department of General Surgery, Yuebei People’s Hospital Affiliated to Shantou University School of Medicine, Shantou 515063, Guangdong Province, China
You-Yong Zhang, Department of Radiology, Yuebei People’s Hospital Affiliated to Shantou University School of Medicine, Shantou 515063, Guangdong Province, China
De-Fei Hong, Department of Hepatobiliary and Pancreatic Surgery, Zhejiang Provincial People’s Hospital, Hangzhou 310009, Zhejiang Province, China
Xiu-Jun Cai, Department of Hepatobiliary and Pancreatic Surgery, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou 310016, Zhejiang Province, China
Author contributions: Peng SY and Wang XA contributed equally to this work; Peng SY and Wang XA wrote and revised the manuscript; Peng SY designed the TBPVE and TELPP approaches; Huang CY and Zhang YY performed the TBPVE and TACE and prepared the figures; all the authors participated in the TELPP operations except Zhang YY.
Supported by the National Natural Science Foundation of China, No. 81570559 and No. 81272673.
Conflict-of-interest statement: All the authors deny any form of conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Shu-You Peng, MD, FACS(Hon), Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou 310009, Zhejiang Province, China. zrwkpsy@zju.edu.cn
Telephone: +86-571-87783766
Received: January 28, 2017
Peer-review started: February 8, 2017
First decision: March 16, 2017
Revised: April 3, 2017
Accepted: May 4, 2017
Article in press: May 4, 2017
Published online: June 21, 2017
Processing time: 142 Days and 14.1 Hours
Abstract

Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has been recently demonstrated as a method to induce rapid and extensive hypertrophy within a short time and has been employed for a variety of primary and metastatic liver tumors. However, controversies remain due to its high morbidity and mortality. To enable safer surgery, liver surgeons have searched for better technical modifications, such as partial ALPPS, mini-ALPPS, minimally invasive ALPPS, and Terminal branches portal vein Embolization Liver Partition for Planned hepatectomy (TELPP). It seems that TELPP is very promising, because it has the main advantage of ALPPS - the rapid increase of future liver remnant volume, but the morbidity and mortality are much lower because only one surgical operation is required.

Keywords: Associating liver partition and portal vein ligation for staged hepatectomy; Terminal branches portal vein embolization; Terminal branches portal vein embolization liver partition for planned hepatectomy; Transarterial chemoembolization

Core tip: Many technical modifications have been proposed for associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) due to its high morbidity and mortality. We described a new one, named Terminal branches portal vein Embolization Liver Partition for Planned hepatectomy, which uses a different method to interrupt the communicating portal vein branches, not by manipulation of the liver parenchyma but by the implementation of the embolization of terminal portal vein branches between both sides of the liver. It has the main advantage of ALPPS - the rapid increase of future liver remnant volume, but the morbidity and mortality are much lower.