ArticlePatient safety in surgery2016
Monitoring of liver function in a 73-year old patient undergoing 'Associating Liver Partition and Portal vein ligation for Staged hepatectomy': case report applying the novel liver maximum function capacity test.
Article in Patient safety in surgery, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Negative impact of chemotherapy on kinetic growth rate of the future liver remnant if applied following PVE or ALPPS.PloS one · 2025Article
- Article
- Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) in colorectal liver metastases: review of the literature.Clinical and experimental hepatology · 2021Review
- Liver venous deprivation versus portal vein embolization before major hepatectomy: future liver remnant volumetric and functional changes.Hepatobiliary surgery and nutrition · 2020Article
- Article
- Role of associating liver partition and portal vein ligation in staged hepatectomy (ALPPS)-strategy for colorectal liver metastases.Translational gastroenterology and hepatology · 2018Review
- Functional shift with maintained regenerative potential following portal vein ligation.Scientific reports · 2017Article
- Hypertrophy and Liver Function in ALPPS: Correlation with Morbidity and Mortality.Visceral medicine · 2017Review
- Extended liver venous deprivation before major hepatectomy induces marked and very rapid increase in future liver remnant function.European radiology · 2017Article
- Use of the liver maximum function capacity test (LiMAx) for the management of liver resection in cirrhosis - A case of hypopharyngeal cancer liver metastasis.International journal of surgery case reports · 2017Article
- Liver function: homogenous or not?HPB : the official journal of the International Hepato Pancreato Biliary Association · 2016Article
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Authors and funding
10 authors.
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Abstract
backgroundThe two-stage liver resection combining in situ liver transection with portal vein ligation, also referred to as ALPPS (Associating Liver Partition and Portal vein ligation for Staged hepatectomy), has been described as a promising method to increase the resectability of liver tumors. However, one of the most important issues regarding the safety of this procedure is the optimal timing of the second stage at the point of sufficient hypertrophy of the future liver remnant. The recently developed liver maximum function capacity test (LiMAx) can be applied to monitor the liver function postoperatively and hence could be a useful tool for decision-making regarding the timing of the second stage of ALPPS. CASE PRESENTATION: A 73-year-old female patient presented with metachronous colorectal liver metastasis comprising the complete right liver lobe as well as segment IV. Due to an insufficient future liver remnant (19.3 %; segments II and III of the liver) and a low future liver remnant:body weight ratio (0.28 %) the decision was made to perform an ALPPS-procedure in order to avoid development of postoperative small-for-size syndrome. Despite a formally sufficient increase of the FLR to 30.8 % within 7 days after the first step of ALPPS, the liver function was seen to only slowly increase as expressed by a LiMAx value of 245 μg/h/kg (baseline of 282 μg/h/kg prior to surgery). By means of the LiMAx test, sufficient increase of liver function eventually was detected by postoperative day 11 (LiMAx value of 371 μg/h/kg; FLR 35.2 %) so that the second step of ALPPS (completion of hepatectomy) was performed with no signs of liver failure during further clinical course.
conclusionPerforming ALPPS we have observed a significant difference between the increase in future liver remnant volume and function applying the LiMAx test. The latter tool thus might proof valuable for application in two-stage liver resection to avoid postoperative small-for-size syndrome.
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