Cargando…
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...
Autores principales: | , , , , , , |
---|---|
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 |
_version_ | 1785025570024718336 |
---|---|
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. |
format | Online Article Text |
id | pubmed-10101734 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT laurinaviciuspetras rightsidedalppsafterpreoperativeemergencyembolizationoftherighthepaticarterycasereportwithafavorableanatomy AT mullerphilipc rightsidedalppsafterpreoperativeemergencyembolizationoftherighthepaticarterycasereportwithafavorableanatomy AT ghafoorsoleen rightsidedalppsafterpreoperativeemergencyembolizationoftherighthepaticarterycasereportwithafavorableanatomy AT jonasjanphilipp rightsidedalppsafterpreoperativeemergencyembolizationoftherighthepaticarterycasereportwithafavorableanatomy AT oberkoflerchristiane rightsidedalppsafterpreoperativeemergencyembolizationoftherighthepaticarterycasereportwithafavorableanatomy AT clavienpierrealain rightsidedalppsafterpreoperativeemergencyembolizationoftherighthepaticarterycasereportwithafavorableanatomy AT petrowskyhenrik rightsidedalppsafterpreoperativeemergencyembolizationoftherighthepaticarterycasereportwithafavorableanatomy |