Wen XD, Xiao L. Associating liver partition and portal vein ligation for staged hepatectomy in the treatment of colorectal cancer liver metastases. World J Gastrointest Surg 2021; 13(8): 814-821 [PMID: 34512905 DOI: 10.4240/wjgs.v13.i8.814]
Corresponding Author of This Article
Le Xiao, MD, Surgeon, General Surgery Center, The General Hospital of Western Theater Command, No. 270 Rongdu Avenue, Jinniu District, Chengdu 610083, Sichuan Province, China. xiaole007@sina.com
Research Domain of This Article
Surgery
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
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/
World J Gastrointest Surg. Aug 27, 2021; 13(8): 814-821 Published online Aug 27, 2021. doi: 10.4240/wjgs.v13.i8.814
Associating liver partition and portal vein ligation for staged hepatectomy in the treatment of colorectal cancer liver metastases
Xu-Dong Wen, Le Xiao
Xu-Dong Wen, Department of Gastroenterology and Hepatology, Chengdu First People’s Hospital, Chengdu 610016, Sichuan Province, China
Le Xiao, General Surgery Center, The General Hospital of Western Theater Command, Chengdu 610083, Sichuan Province, China
Author contributions: Wen XD participated in the writing of the main manuscript; Xiao L designed the outline and performed the revision of the manuscript.
Supported bythe Sichuan Provincial Science and Technology Department Application Foundation Project, No. 2021YJ0198; Scientific Research Project of Sichuan Provincial Health Commission, No. 20PJ196; and Research Foundation of Chengdu Medical College, No. CYZ19-07.
Conflict-of-interest statement: There is no conflict of interest associated with any of the senior authors or other coauthors who contributed to the preparation of this manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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/
Corresponding author: Le Xiao, MD, Surgeon, General Surgery Center, The General Hospital of Western Theater Command, No. 270 Rongdu Avenue, Jinniu District, Chengdu 610083, Sichuan Province, China. xiaole007@sina.com
Received: February 9, 2021 Peer-review started: February 9, 2021 First decision: May 13, 2021 Revised: May 24, 2021 Accepted: July 13, 2021 Article in press: July 13, 2021 Published online: August 27, 2021 Processing time: 191 Days and 19.1 Hours
Abstract
Colorectal cancer (CRC) is a common malignancy of the digestive system. Colorectal liver cancer metastasis (CRLM) occurs in approximately 50% of the patients and is the main cause of CRC mortality. Surgical resection is currently the most effective treatment for CRLM. However, given that the remnant liver volume after resection should be adequate, only a few patients are suitable for radical resection. Since Dr. Hans Schlitt first performed the associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) for CRLM in 2012, ALPPS has received considerable attention and has continually evolved in recent years. This review explains the technical origin of the ALPPS procedure for CRLM and evaluates its efficacy, pointing to its favorable postoperative outcomes. We also discuss the patient screening strategies and optimization of ALPPS to ensure long-term survival of patients with CRLM in whom surgery cannot be performed. Finally, further directions in both basic and clinical research regarding ALPPS have been proposed. Although ALPPS surgery is a difficult and high-risk technique, it is still worth exploration by experienced surgeons.
Core Tip: Several previous reviews have discussed the associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) technique and its applications. However, this is the first review on ALPPS in colorectal liver cancer metastasis, in which the technical evolution of the procedure is described, its safety and efficacy are evaluated, patient selection process and technique improvement are discussed, and further directions are proposed.
