Current position of ALPPS in the surgical landscape of CRLM treatment proposals

Figure 1 Example of strategy using a semi-automated 3D volumetry system. Hepavision^® MEVIS. A: 3D volumetry before associating liver partition and portal vein ligation for staged hepatectomy (ALPPS): future liver remnant (FLR) 26%; B: Two weeks after ALPPS volumetry of FLR: 43% (increase of 65%).

Figure 2 Intraoperative images of associating liver partition and portal vein ligation for staged hepatectomy in our center. A, B: 1^st Step procedure with apposition of colored loop (red for the right hepatic artery, yellow for the right hepatic duct) and of T-drainage. C, D: Easy identification of loops during the second step and opened specimen of R0-resection of colo-rectal liver metastasis.