Case Report
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jan 27, 2018; 10(1): 1-5
Published online Jan 27, 2018. doi: 10.4240/wjgs.v10.i1.1
Associating liver partition and portal vein ligation for staged hepatectomy for extensive alveolar echinococcosis: First case report in the literature
Sami Akbulut, Egemen Cicek, Mehmet Kolu, Tevfik Tolga Sahin, Sezai Yilmaz
Sami Akbulut, Egemen Cicek, Tevfik Tolga Sahin, Sezai Yilmaz, Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya 44280, Turkey
Mehmet Kolu, Department of Radiology, Inonu University Faculty of Medicine, Malatya 44280, Turkey
Author contributions: Akbulut S, Sahin TT and Yilmaz S designed the report; Cicek E collected the patient’s clinical data; Kolu M performed the radiological image design; Akbulut S and Yilmaz S analyzed the data and wrote the paper.
Informed consent statement: The patient involved in this study gave his informed written consent prior to study enrollment, authorizing the use and disclosure of his protected health information.
Conflict-of-interest statement: The author declares no potential 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: Sami Akbulut, MD, Associate Professor, Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Elazig Yolu 10 Km, Malatya 44280, Turkey. akbulutsami@gmail.com
Telephone: +90-422-3410660 Fax: +90-422-3410036
Received: October 31, 2017
Peer-review started: November 1, 2017
First decision: December 1, 2017
Revised: December 4, 2017
Accepted: December 13, 2017
Article in press: December 13, 2017
Published online: January 27, 2018
Abstract

Alveolar echinococcosis (AE) is a zoonotic disease that is caused by Echinococcus multilocularis that affects liver and a variety of organs and tissues. It differs from other echinococcal disease because it shows tumor like behavior in the affected organ and tissues. The treatment of choice is concomitant medical therapy and resection with negative margins. Nevertheless, resection with the intent of negative margins (R0) may lead to serious complications such as liver failure. In the present case report, we used Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy (ALPPS) procedure, which was defined in 2012 by Schnitzbauer et al, in a 28-year-old male patient to avoid complications of major liver resection in order to treat alveolar echinococcosis. Until now, we have not encountered any study using ALPPS procedure for the treatment of alveolar echinococcosis. In the present case report we aimed to show that ALPPS procedure can be safely performed for margin-negative resection of primary or recurrent AE that shows a tumor like behavior. It is our opinion that this procedure should be performed in centers that have expertise and sufficient technical capacity to perform liver transplantation and advanced liver surgery.

Keywords: Alveolar echinococcosis, Extensive disease, Associating liver partition portal vein ligation, Curative management

Core tip: We have shown the feasibility and efficacy of Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy (ALPPS) procedure -initially described for the resection of advanced tumors including colorectal liver metastasis, hilar cholangiocarcinoma and to a lesser extent hepatocellular carcinoma-in resection of recurrent hepatic alveolar echinococcosis in a young patient. In selected patient groups with benign liver disease with extensive hepatic involvement ALPPS can be safely used in centers which have expertise in liver transplantation and major hepatic surgery. According to our knowledge, the present patient is the first extensive hepatic AE case that ALPPS procedure has been applied in the literature.