SynthesisFrontiers in pediatrics2022
Evidence on Indications and Techniques to Increase the Future Liver Remnant in Children Undergoing Extended Hepatectomy: A Systematic Review and Meta-Analysis of Individual Patient Data.
Synthesis in Frontiers in pediatrics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 13 citations in OpenAlex.
- Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy (ALPPS) in Children with Advanced Hepatoblastoma-Lessons from a Case Series and Literature Review.Children (Basel, Switzerland) · 2026Article
- [Surgical management of children with liver tumors in Germany : Evidence, care structures and future perspectives].Chirurgie (Heidelberg, Germany) · 2026Review
- Outcomes of major liver resection for children with hepatoblastoma weighing less than 10 kg: avoiding liver transplantation with extended or extreme resection.Pediatric surgery international · 2025Article
- Children are not just small adults: Comment on "Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) for pediatric mesenchymal hamartoma: A case report" by Caballes et De Lara.Turkish journal of surgery · 2025Article
- Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) for pediatric mesenchymal hamartoma: A case report.Turkish journal of surgery · 2025Article
- Associating Liver Partition with Portal Vein Ligation and Staged Hepatectomy (ALPPS): Feasibility of Performing in Infants with Large Hepatic Tumor-Case Report.Healthcare (Basel, Switzerland) · 2025Article
- Case Report: ALPPS hepatectomy, an alternative to liver transplantation in central PRETEXT III hepatoblastomas: a case series.Frontiers in pediatrics · 2024Article
- Surgical management in hepatoblastoma: points to take.Pediatric surgery international · 2023Review
- Case report: Portal vein ligation: lessons from patients with PRETEXT III hepatoblastoma in restoring future liver remnant before major hepatectomy and literature review.Frontiers in surgery · 2023Article
- Embolization in Pediatric Patients: A Comprehensive Review of Indications, Procedures, and Clinical Outcomes.Journal of clinical medicine · 2022Review
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Techniques to increase the future liver remnant (FLR) have fundamentally changed the indications and criteria of resectability in adult liver surgery. In pediatric patients however, these procedures have rarely been applied and the potential benefit or harm as well as suited indications are unclear. Methods: A systematic literature search of MEDLINE, Web of Science, and CENTRAL was conducted. Based on a PRISMA-compliant, predefined methodology, all studies reporting pediatric patients (< 18y) undergoing liver resection with either associating liver partition and portal vein ligation for stages hepatectomy (ALPPS) or preoperative portal vein embolization or ligation (PVE/PVL) were included. Baseline data, periinterventional morbidity, increase of FLR and outcomes were analyzed. Results: 15 studies reporting on 21 pediatric patients with a mean age of 4 years and 7 months (range 1.8 months - 17 years) were included. 12 ALPPS procedures, 8 PVE and 1 PVL were performed. The applied criteria for performing ALPPS or PVE were heterogenous and thresholds for minimally acceptable FLR varied. Mean FLR [% of total liver volume] before the intervention was 23.6% (range 15.0 - 39.3%) in the ALPPS group and 31.4% (range 21.5 - 56.0%) in the PVE group. Mean increase of FLR before stage 2 resection was 69.4% (range 19.0 - 103.8%) for ALPPS and 62.8% (range 25.0 - 108.0%) after PVE. No postoperative death occurred, one early intrahepatic recurrence after an ALPPS procedure was reported. Overall postoperative morbidity was 23.8%. Conclusion: Validated criteria for minimal FLR in pediatric liver resection are lacking and so are clear indications for ALPPS or PVE. In special cases, ALPPS and PVE can be valuable techniques to achieve complete resection of pediatric liver tumors. However, more data are needed, and future studies should focus on a definition and validation of posthepatectomy liver failure as well as the minimally needed FLR in pediatric patients undergoing extended hepatectomy. Systematic Review Registration: [www.clinicaltrials.gov], identifier [PROSPERO 2021 CRD42021274848].
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