Role of alpps procedure in the treatment strategy of colorectal liver metastases (Literature review)
Authors: A.Iu. Navmatulya, S.А. Savchuk, F.R. Almukhametova, O.Z. Bratov, A.Е. Tsaregorodtsev, A.I. Kuznetsov, P.V. Balakhnin, B.I. Miroshnikov, V.М. Moiseenko
ALPPS is the option for two-staged hepatectomy for patients with future liver remnants <30%, contributing to its compensatory increase by reducing the portal blood circulation. At the first stage the branch of the hepatic portal vein is ligated with simultaneous transection of the parenchyma. Hypertrophy of future liver remnant reduces the risk of hepatic failure after extended hepatectomy, which makes it possible to perform radical surgery in cases of initially unresectable metastases. The high rate of postoperative complications limits active implementation of this technique. ALPPS with precise patient selection increases odds of complete tumor resection and overall survival rate.