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Right-sided ALPPS after preoperative emergency embolization of the right hepatic artery: case report with a favorable anatomy

In patients with extensive colorectal liver metastases (CRLM) and insufficient future liver remnant (FLR) a faster and more effective FLR augmentation than portal vein embolization is the associating liver partition and portal vein ligation in staged hepatectomy (ALPPS). Before ALPPS, the presence o...

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Autores principales: Laurinavicius, Petras, Müller, Philip C, Ghafoor, Soleen, Jonas, Jan Philipp, Oberkofler, Christian E, Clavien, Pierre-Alain, Petrowsky, Henrik
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10101734/
https://www.ncbi.nlm.nih.gov/pubmed/37064062
http://dx.doi.org/10.1093/jscr/rjad180
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author Laurinavicius, Petras
Müller, Philip C
Ghafoor, Soleen
Jonas, Jan Philipp
Oberkofler, Christian E
Clavien, Pierre-Alain
Petrowsky, Henrik
author_facet Laurinavicius, Petras
Müller, Philip C
Ghafoor, Soleen
Jonas, Jan Philipp
Oberkofler, Christian E
Clavien, Pierre-Alain
Petrowsky, Henrik
author_sort Laurinavicius, Petras
collection PubMed
description In patients with extensive colorectal liver metastases (CRLM) and insufficient future liver remnant (FLR) a faster and more effective FLR augmentation than portal vein embolization is the associating liver partition and portal vein ligation in staged hepatectomy (ALPPS). Before ALPPS, the presence of arterial blood supply to the subsequently resected hemiliver must be ensured. We present a case with neoadjuvant-treated CRLM and insufficient FLR who developed a large intrahepatic hematoma after liver biopsy. For continuous bleeding, the right hepatic artery was embolized. Fortunately, an accessory right hepatic artery arising from the superior mesenteric artery was present, which enabled the ALPPS procedure to be performed. After ALPPS, the patient did not experience liver failure. The case exemplifies that preoperative evaluation of the vascular supply of the liver is of paramount importance in advanced hepatic surgery such as ALPPS.
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spelling pubmed-101017342023-04-14 Right-sided ALPPS after preoperative emergency embolization of the right hepatic artery: case report with a favorable anatomy Laurinavicius, Petras Müller, Philip C Ghafoor, Soleen Jonas, Jan Philipp Oberkofler, Christian E Clavien, Pierre-Alain Petrowsky, Henrik J Surg Case Rep Case Report In patients with extensive colorectal liver metastases (CRLM) and insufficient future liver remnant (FLR) a faster and more effective FLR augmentation than portal vein embolization is the associating liver partition and portal vein ligation in staged hepatectomy (ALPPS). Before ALPPS, the presence of arterial blood supply to the subsequently resected hemiliver must be ensured. We present a case with neoadjuvant-treated CRLM and insufficient FLR who developed a large intrahepatic hematoma after liver biopsy. For continuous bleeding, the right hepatic artery was embolized. Fortunately, an accessory right hepatic artery arising from the superior mesenteric artery was present, which enabled the ALPPS procedure to be performed. After ALPPS, the patient did not experience liver failure. The case exemplifies that preoperative evaluation of the vascular supply of the liver is of paramount importance in advanced hepatic surgery such as ALPPS. Oxford University Press 2023-04-13 /pmc/articles/PMC10101734/ /pubmed/37064062 http://dx.doi.org/10.1093/jscr/rjad180 Text en Published by Oxford University Press and JSCR Publishing Ltd. © The Author(s) 2023. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Laurinavicius, Petras
Müller, Philip C
Ghafoor, Soleen
Jonas, Jan Philipp
Oberkofler, Christian E
Clavien, Pierre-Alain
Petrowsky, Henrik
Right-sided ALPPS after preoperative emergency embolization of the right hepatic artery: case report with a favorable anatomy
title Right-sided ALPPS after preoperative emergency embolization of the right hepatic artery: case report with a favorable anatomy
title_full Right-sided ALPPS after preoperative emergency embolization of the right hepatic artery: case report with a favorable anatomy
title_fullStr Right-sided ALPPS after preoperative emergency embolization of the right hepatic artery: case report with a favorable anatomy
title_full_unstemmed Right-sided ALPPS after preoperative emergency embolization of the right hepatic artery: case report with a favorable anatomy
title_short Right-sided ALPPS after preoperative emergency embolization of the right hepatic artery: case report with a favorable anatomy
title_sort right-sided alpps after preoperative emergency embolization of the right hepatic artery: case report with a favorable anatomy
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10101734/
https://www.ncbi.nlm.nih.gov/pubmed/37064062
http://dx.doi.org/10.1093/jscr/rjad180
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