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16.11.2019 | Original Article | Ausgabe 7/2019

Langenbeck's Archives of Surgery 7/2019

The role of ALPPS in intrahepatic cholangiocarcinoma

Zeitschrift:
Langenbeck's Archives of Surgery > Ausgabe 7/2019
Autoren:
Jan Bednarsch, Zoltan Czigany, Isabella Lurje, Pavel Strnad, Philipp Bruners, Tom Florian Ulmer, Marcel den Dulk, Georg Lurje, Ulf Peter Neumann
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s00423-019-01838-2) contains supplementary material, which is available to authorized users.
Georg Lurje and Ulf Peter Neumann contributed equally to this work.

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Abstract

Purpose

Surgical resection constitutes the mainstay of curative treatment for intrahepatic cholangiocarcinoma (iCCA). Complete tumor clearance can only be achieved with extended liver resections and as such, associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) may facilitate surgical resectability. The present study aims to evaluate the technical feasibility and oncologic outcome of ALPPS in iCCA.

Methods

A set of 14 patients who underwent ALPPS in a single center between 2011 and 2017 were statistically analyzed for perioperative and oncologic outcome.

Results

Of all patients undergoing stage 1 of ALPPS, 12 (86%) patients were subsequently completed in stage 2 surgery. Patients who completed the ALPPS procedure showed a median overall survival (OS) of 4.2 years and a 3-year survival of 64%. Individuals without lymphatic metastases (n = 7) were all alive 1 year after surgery and if deceased, they died more than 4 years after surgery, while no patient with lymphatic metastases (n = 5) was alive 1 year after surgery.

Conclusion

This is the largest single-center experience of ALPPS in iCCA currently available in the literature showing excellent technical feasibility and encouraging overall survival in these patients.

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