| Autor: |
Elissaios Kontis, Parthi Srinivasan, Michail Pizanias, Rajaventhan Srirajaskanthan, John Ramage, Evangelos Prassas, Andreas Prachalias, Michail Papamichail |
| Rok vydání: |
2018 |
| Předmět: |
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| Zdroj: |
Liver. |
| DOI: |
10.1136/gutjnl-2018-bsgabstracts.257 |
| Popis: |
Introduction Hepatic resection has emerged as an effective treatment for secondary liver neuroendocrine tumours. ‘Associated liver partition and portal vein ligation for staged hepatectomy’ (ALPPS) allows resection of liver tumours in two steps. We present our experience in ALPPS procedure as a Method which can minimise small for size syndrome, and provide an oncological benefit to borderline resectable neuroendocrine tumours within acceptable safety profile. Methods 4 patients (male: female: 1:1) underwent ALPPS procedure for clearance of the metastatic liver disease. Liver segments I, IV-VIII were resected for each patient. Two of the patients had bi-lobar disease. Clearance to future liver remnant (FLR) was achieved with non-anatomical liver resection in one case and with irreversible electroporation to the other as the lesion was adjacent to the left hepatic vein during the 1 st stage of the ALPPS procedure. Two patients underwent ALPPS as a salvage procedure after failed portal vein embolization and portal vein ligation respectively. Results Median increase of FLR volume was 139.25% (range 40.00%–157.78%). Median hospital stay was 28.5 days (range 23–36). Histology report revealed two complete (R0) and two incomplete (R1) resections. Background liver histology revealed steatosis on two occasions and fibrosis on another. 90 day mortality was zero. Two patients developed grade II complications as per Clavien-Dindo classification, one grade IIIa and one IIIb. One patient is disease free after 36 months,. One patient died two years later from viral infection, and two had recurrence in liver and lymph nodes and were treated with microwave ablation and lymphadenectomy respectively. Conclusions ALPPS procedure allows performing major liver resections for high volume neuroendocrine metastases while minimising the risk of post-operative liver failure. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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