A literature review of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS): so far, so good

Recently, associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) emerged as a novel surgical strategy to induce a rapid and large hypertrophy of the future liver remnant (FLR). We conducted a computerized search using PubMed and Google Scholar for reports published between March 2012 and July 2016 using mesh headings and key words relating to the ALPPS surgical procedure. The promising results obtained up to date are difficult to interpret due to the heterogeneous group of patients with different underlying pathologies and different chemotherapy schemes. The ALPPS appears as a feasible strategy to be included in the multimodal treatment menu of selected oncological patients. The ALPPS approach can be implemented with acceptable postoperative morbidity and mortality in experienced centers and only in carefully selected patients. This strategy might substitute classic 2-stage hepatectomy in certain patients if future evidence shows superior or equal long-term outcomes.