ArticleWorld journal of surgery2014
ALPPS offers a better chance of complete resection in patients with primarily unresectable liver tumors compared with conventional-staged hepatectomies: results of a multicenter analysis.
Article in World journal of surgery, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02164292 (Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy), which is not on this map. Cited by 124 papers, 9 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy (ALPPS): Safety, Feasibility and Efficacy at a Single Center
Who cites it
124 citing papers in PubMed, 9 syntheses or guidelines pooled it, 281 citations in OpenAlex.
- Efficacy and safety of different options for liver regeneration of future liver remnant in patients with liver malignancies: a systematic review and network meta-analysis.World journal of surgical oncology · 2022Pooled it
- Conventional Two-Stage Hepatectomy or Associating Liver Partitioning and Portal Vein Ligation for Staged Hepatectomy for Colorectal Liver Metastases? A Systematic Review and Meta-Analysis.Frontiers in oncology · 2020Pooled it
- Partial ALPPS versus complete ALPPS for staged hepatectomy.BMC gastroenterology · 2019Pooled it
- Pooled it
- Associating liver partition and portal vein ligation versus 2-stage hepatectomy: A meta-analysis.Medicine · 2018Pooled it
- Operative Results and Oncologic Outcomes of Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy (ALPPS) Versus Two-Stage Hepatectomy (TSH) in Patients with Unresectable Colorectal Liver Metastases: A Systematic Review and Meta-Analysis.World journal of surgery · 2018Pooled it
- Associating liver partition and portal vein ligation for staged hepatectomy versus conventional two-stage hepatectomy: a systematic review and meta-analysis.World journal of surgical oncology · 2017Pooled it
- Pooled it
- ALPPS Procedure for Extended Liver Resections: A Single Centre Experience and a Systematic Review.PloS one · 2015Pooled it
- Establishing the Minimum Future Liver Remnant Volume for Safe Hepatectomy.Journal of the American College of Surgeons · 2026Article
- Hepatic Hypertrophy Techniques: Comparing Perioperative Outcomes of Liver Venous Deprivation (LVD) and Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy-Variants (vALPPS) Among Two Referral Centers.Annals of surgical oncology · 2026Article
- Associated Radiofrequency Ablation and Portal Vein Ligation for Staged Hepatectomy Compared to Portal Vein Ligation Induces Prolonged and Enhanced Liver Regenerative Response.European surgical research. Europaische chirurgische Forschung. Recherches chirurgicales europeennes · 2026Article
- Initial experience with Double-vein Embolization in Hungary.European journal of radiology open · 2024Article
- Adjuvant chemotherapy is associated with better oncological outcomes after ALPPS for colorectal liver metastases.Updates in surgery · 2024Observational
- Full robotic versus open ALPPS: a bi-institutional comparison of perioperative outcomes.Surgical endoscopy · 2024Article
- Liver regeneration after portal and hepatic vein embolization improves overall survival compared with portal vein embolization alone: mid-term survival analysis of the multicentre DRAGON 0 cohort.The British journal of surgery · 2024Article
- Robotic ALPPS for primary and metastatic liver tumours: short-term outcomes versus open approach.Updates in surgery · 2024Article
- Review
- Essential updates 2021/2022: Update in surgical strategy for perihilar cholangiocarcinoma.Annals of gastroenterological surgery · 2023Review
- ALPPS versus portal vein embolization for hepatitis B virus-associated hepatocellular carcinoma: a delicate balance between volume and morbidity.Hepatobiliary surgery and nutrition · 2023Article
64 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
12 authors at 5 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPortal vein occlusion to increase the size of the future liver remnant (FLR) is well established, using portal vein ligation (PVL) or embolization (PVE) followed by resection 4-8 weeks later. Associating liver partition with portal vein ligation for staged hepatectomy (ALPPS) combines PVL and complete parenchymal transection, followed by hepatectomy within 1-2 weeks. ALPPS has been recently introduced but remains controversial. We compare the ability of ALPPS versus PVE or PVL for complete tumor resection.
methodsA retrospective review of all patients undergoing ALPPS or conventional staged hepatectomies using PVL or PVE at four high-volume HPB centres between 2003 and 2012 was performed. Patients with primary liver tumors and liver metastases were included. Primary endpoint was complete tumor resection. Secondary endpoints include 90-day mortality, complications, FLR increase, time to resection, and tumor recurrence.
resultsForty-eight patients with ALPPS were compared with 83 patients with conventional-staged hepatectomies. Eighty-three percent (40/48 patients) of ALPPS patients achieved complete resection compared with 66 % (55/83 patients) in PVE/PVL (odds ratio 3.34, p = 0.027). Ninety-day mortality in ALPPS and PVE/PVL was 15 and 6 %, respectively (p = 0.2). Extrapolated growth rate was 11 times higher in ALPPS (34.8 cc/day; interquartile range (IQR) 26-49) compared with PVE/PVL (3 cc/day; IQR2-6; p = 0.001). Tumor recurrence at 1 year was 54 versus 52 % for ALPPS and PVE/PVL, respectively (p = 0.7).
conclusionsThis study provides evidence that ALPPS offers a better chance of complete resection in patients with primarily unresectable liver tumors at the cost of a high mortality. The technique is promising but should currently not be used outside of studies and registries.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.