What is the ALPPS procedure?
This procedure takes advantage of the ability of the liver to regenerate. When the patient has disease in both lobes of the liver and not enough healthy liver will remain after a conventional resection then this staged procedure is utilized. The disease is removed from the future liver remnant, the portal vein to the healthy liver is maintained and litigated two the side that will be removed. This first stage is followed by a waiting period of at least seven to 10 days and the liver remnant is reassessed. If it has grown to a large enough size, then the second stage is performed where the diseased liver is removed.
Associating Liver Partition and Portal vein ligation for Staged hepatectomy procedure can be done laparoscopically with robotic assistance if all of the disease can be removed. This minimizes the postoperative recovery and allows the patient to go home between the procedures.
Results and what to expect after the ALPPS procedure:
The results of this surgery vary depending on the health of the patient and the aggressiveness and extent of the underlying disease process. Operations that require reconstruction of the liver bile outflow carry a higher morbidity because this joint can leak or narrow down.
The underlying disease may be a primary liver tumor that extends into both lobes or a tumor that has spread from another site into both lobes of the liver. This procedure is usually used as a last resort to remove all of the disease from the patient to allow a curative resection. If the procedure cannot be performed, then the only option available to the patient is palliative chemotherapy and/or radiation therapy. This is an extensive operation that should only be done in tertiary care centers like ours that has a multidisciplinary team to provide this care.