Stavrou Gregor A, Donati Marcello, Fard-Aghaie Mohammad H, Zeile Martin, Huber Tessa M, Stang Axel, Oldhafer Karl J
General and Visceral Surgery, Surgical Oncology, Asklepios Hospital Barmbek, Hamburg, Germany.
Semmelweis Medical Faculty, Campus Hamburg, Hamburg, Germany.
Visc Med. 2017 Dec;33(6):456-461. doi: 10.1159/000479476. Epub 2017 Nov 30.
ALPPS (associating liver partition and portal vein ligation for staged hepatectomy) was introduced only 10 years ago and has gained wide acceptance as a variation of staged procedures in liver surgery. It has been criticized for its high morbidity and mortality, which all centers reported in their initial series.
After a world expert meeting in Hamburg in 2015 where all experts in the field met to discuss this method, caveats were extracted and formulated. We researched our complete prospective ALPPS database to see if the recommendations had any impact on outcome.
In total, we performed 58 ALPPS procedures in our center. 33 patients were operated on before, 25 after the meeting. Results in terms of morbidity and mortality were significantly better after the meeting, as were patient selection and strategy.
In our own center's experience, the implementation of the meetings' recommendations and the information gathered through this valuable exchange had a dramatic impact on results. Having performed 58 ALPPS procedures in total, we can now conclude that ALPPS has become much safer in our hands since the 2015 meeting and that morbidity and mortality are no longer the issue to be discussed. Future research must focus on oncologic outcomes in these patients.
联合肝脏分隔和门静脉结扎的分期肝切除术（ALPPS）于10年前才被提出，并作为肝脏手术分期手术的一种变体而被广泛接受。它因其高发病率和死亡率而受到批评，所有中心在其最初的系列报道中均有提及。
在2015年于汉堡举行的一次世界专家会议上，该领域的所有专家齐聚一堂讨论此方法，之后提炼并制定了注意事项。我们研究了我们完整的前瞻性ALPPS数据库，以查看这些建议是否对结果产生了任何影响。
我们中心总共进行了58例ALPPS手术。33例患者在会议前接受手术，25例在会议后接受手术。会议之后，在发病率和死亡率方面的结果明显更好，患者选择和策略方面也是如此。
根据我们中心自身的经验，会议建议的实施以及通过这次宝贵交流收集到的信息对结果产生了巨大影响。我们总共进行了58例ALPPS手术，现在可以得出结论，自2015年会议以来，ALPPS在我们手中已变得更加安全，发病率和死亡率不再是需要讨论的问题。未来的研究必须聚焦于这些患者的肿瘤学结局。
