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| Monosegmental ALPPS combined with ante-situm liver resection: A novel strategy for end-stage hepatic alveolar echinococcosis |
| Ji-Chao Tang a , b , # , Wang-Jie Suolang c , # , Chong Yang a , Yi Wang a , Ming-Wu Tian a , b , Yu Zhang a , ∗ |
a Organ Transplantation Center, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu 610072, China
b School of Clinical Medical Sciences, Southwest Medical University, Luzhou 646000, China
c NHC Key Laboratory of Echinococcosis Prevention and Control, Lhasa 850000, China
∗ Corresponding author.
E-mail address: zhangyuqg@med.uestc.edu.cn (Y. Zhang).
# Contributed equally. |
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Abstract Hepatic alveolar echinococcosis (HAE) is a lethal infectious disease caused by the larval stage of Echinococcus multilocularis. To date, radical resection combined with albendazole is considered the major treatment for patients with HAE. However, many patients miss the best time for diagnosis and resection due to patient delay, doctor delay, or long distances to specialized centers. Allogeneic liver transplantation is an important method for the treatment of end-stage HAE, but its application is limited due to the shortage of organ donors, long-term use of immunosuppressive agents and high recurrence rates [1]. Recently, ex vivo liver resection and autotransplantation has been used for end-stage HAE with invasion of multiple intrahepatic structures that could not be reconstructed in vivo [2,3]. However, the insufficient future liver remnant (FLR), which may cause posthepatectomy liver failure, makes ex vivo liver resection and autotransplantation unfeasible for some patients. For patients suffering from end-stage HAE with insufficient FLR and infiltration of the hepatocaval confluence or the retrohepatic vena cava, we developed a novel strategy that consists of monosegmental associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) and ante-situm liver resection.
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2022, Vol. 21 
