Laparoscopic ALPPS
摘要
As an innovative surgical method, associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) represents a significant advancement in surgical techniques developed in recent years. It integrates the essence of portal vein ligation and traditional two-step hepatectomy, which is hailed as a milestone breakthrough in the field of hepatobiliary surgery [1]. By altering the hepatic blood flow distribution and inducing an inflammatory response, ALPPS prompts rapid hypertrophy of the remaining liver parenchyma within a short term. This enhances the liver’s volume to increase tolerance to extreme hepatectomy effectively and reduces the incidence of postoperative liver failure. ALPPS provides a viable option for curative surgical intervention in cases of advanced or multifocal liver malignancies, whereas conventional resection approaches may be inadequate [2]. As a result, ALPPS shows favorable clinical efficacy and broad application prospects. Jian Zhou and colleagues first performed the ALPPS procedure in Asia in 2013 [3]. Since then, multiple hepatobiliary surgery centers have documented successful ALPPS cases and reported their experience. Some guiding suggestions for ALPPS in Chinese patients with liver cancer and/or liver cirrhosis were also put forward [4]. In recent years, with advancements in basic research and improvements in surgical approaches, the clinical application of ALPPS has been increasingly performed. Liver surgeons have widely recognized its safety, feasibility, and effectiveness. Remarkable achievements have been realized.