Two cases of ALPPS procedure: simultaneous ALPPS and colorectal resection and ALPPS procedure for hepatic malignancy larger than 15 centimeter.

Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has recently been introduced as a new surgical technique to increase future liver remnant in patients with marginal liver volume contemplating major liver resection. We herein present two cases. Case 1: a 68-year-old male patient with colorectal liver metastasis was referred to our department. The future liver remnant (FLR) was 22%. We performed first-stage ALPPS and colorectal surgery concurrently and second stage operation was performed 8 days later. The patient discharged 28 days after the first-stage ALPPS procedure. Case 2: a 69-year-old male patient with a huge hepatic mass was referred for hepatic surgery. The FLR was 19%. After the first stage of the ALPPS procedure, acute renal failure and posthepatectomy liver failure occurred. The patient began to recover on the 5th postoperative day. At 10 days after the first stage, the patient completed the second-stage procedure. The patient discharged 23 days after the first-stage ALPPS procedure. So far many studies are currently underway to identify factors associated with the morbidity and mortality of the ALPPS procedure, it is necessary to continue follow-up studies and observe the results.