Evolution of minimally invasive techniques and surgical outcomes of ALPPS in Italy: a comprehensive trend analysis over 10 years from a national prospective registry
- 28.03.2023
Erschienen in:
- Verfasst von
- Matteo Serenari
- Francesca Ratti
- Nicola Guglielmo
- Matteo Zanello
- Federico Mocchegiani
- Jacopo Lenzi
- Michele Colledan
- Vincenzo Mazzaferro
- Umberto Cillo
- Alessandro Ferrero
- Matteo Cescon
- Fabrizio Di Benedetto
- Marco Massani
- Gianluca Grazi
- Raffaele Dalla Valle
- Marco Vivarelli
- Giuseppe Maria Ettorre
- Luca Aldrighetti
- Elio Jovine
- ALPPS Italian Registry
- Erschienen in
- Surgical Endoscopy | Ausgabe 7/2023
Abstract
Background
Since 2012, Associating Liver Partition and Portal vein ligation for Staged hepatectomy (ALPPS) has encountered several modifications of its original technique. The primary endpoint of this study was to analyze the trend of ALPPS in Italy over a 10-year period. The secondary endpoint was to evaluate factors affecting the risk of morbidity/mortality/post-hepatectomy liver failure (PHLF).
Methods
Data of patients submitted to ALPPS between 2012 and 2021 were identified from the ALPPS Italian Registry and evaluation of time trends was performed.
Results
From 2012 to 2021, a total of 268 ALPPS were performed within 17 centers. The number of ALPPS divided by the total number of liver resections performed by each center slightly declined (APC = − 2.0%, p = 0.111). Minimally invasive (MI) approach significantly increased over the years (APC = + 49.5%, p = 0.002). According to multivariable analysis, MI completion of stage 1 was protective against 90-day mortality (OR = 0.05, p = 0.040) as well as enrollment within high-volume centers for liver surgery (OR = 0.32, p = 0.009). Use of interstage hepatobiliary scintigraphy (HBS) and biliary tumors were independent predictors of PHLF.
Conclusions
This national study showed that use of ALPPS only slightly declined over the years with an increased use of MI techniques, leading to lower 90-day mortality. PHLF still remains an open issue.
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- Titel
- Evolution of minimally invasive techniques and surgical outcomes of ALPPS in Italy: a comprehensive trend analysis over 10 years from a national prospective registry
- Verfasst von
-
Matteo Serenari
Francesca Ratti
Nicola Guglielmo
Matteo Zanello
Federico Mocchegiani
Jacopo Lenzi
Michele Colledan
Vincenzo Mazzaferro
Umberto Cillo
Alessandro Ferrero
Matteo Cescon
Fabrizio Di Benedetto
Marco Massani
Gianluca Grazi
Raffaele Dalla Valle
Marco Vivarelli
Giuseppe Maria Ettorre
Luca Aldrighetti
Elio Jovine
ALPPS Italian Registry
- Publikationsdatum
- 28.03.2023
- Verlag
- Springer US
- Erschienen in
-
Surgical Endoscopy / Ausgabe 7/2023
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218 - DOI
- https://doi.org/10.1007/s00464-023-09937-4
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