A Case Report of ALPPS for Giant Hepatic Cancer Complicated with Perioperative Acute Renal InjuryMohammad Abdul Mazid, Fu Zhen Wan, Gazi Shahinur Akter, Zheng Hui Ye, Hong Chuan Zhao and Xiao Ping Geng*
Department of Hepatobiliary & Pancreatic Surgery and Liver Transplantation, The First Affiliated Hospital of Anhui medical University, Anhui Medical University, China
- *Corresponding Author:
- Xiao Ping Geng
Department of Hepatobiliary & Pancreatic Surgery and Liver Transplantation
the First Affiliated Hospital of Anhui Medical University
Anhui Medical University, 81 Meishan Road, Sushan District
Hefei 230032, Anhui, China
E-mail: [email protected]
Received date: April 06, 2017; Accepted date: May 02, 2017; Published date: May 09, 2017
Citation: Mazid MA, Wan FZ, Akter GS, Ye ZH, Zhao HC, et al. (2017) A Case Report of ALPPS for Giant Hepatic Cancer Complicated with Perioperative Acute Renal Injury. J Biol Med Science 1:101.
Copyright: © 2017 Mazid AM, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: The aim of the study is to explore the safety and efficacy (outcomes) of two-step Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) combined with hepatic excision and portal vein ligation for the treatment of giant hepatocellular carcinoma. Methods: The clinical data of one patient case of giant right hepatocellular carcinoma treated by ALPPS at the first Affiliated Hospital of Anhui Medical University in April 2016 was analyzed retrospectively. Surgical regimen: For left anterior lobe, the left anterior lobectomy was performed and the hepatic remnant was covered with the artificial vessel suture. After 13 days, the right portal vein was ligated and the right and left hepatectomy were performed. Results: The right hepatic lobe tumor diameter was about 16 cm, and the standard total hepatic volume was 1256.60 m. The remaining proportion of left lobe volume about 347.15 ml weight 0.53 (l/kg), at the time of the second step of ALPPS which was increased to 865.7 ml. The first step operative time was 197 minutes and second operative time was 75 min respectively. The ALPPS first step intraoperative bleeding was 765 ml and 465 ml on the second step. The postoperative recovery of liver function was 6 days for step one and 3 days for step two. The first day after the first step surgery acute oliguria with acute renal injury, creatinine levels were high for 7 days which altered at the second postoperative day of the second step. There was no new complication in the second postoperative period. Conclusion: ALPPS provides a new therapeutic option for hepatocellular carcinoma with insufficient hepatic volume, but it may bring perioperative burden to related organs and cause related complications or even organ failure. The safety of ALPPS in hepatocellular carcinoma patients remain to be assessed and explored.