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Hepatobiliary Surgery and Nutrition 2019年第3期8卷 316-317页

作者： ernesto sparrelid Thomas M.van Gulik Division of Surgery Department of Clinical ScienceIntervention and TechnologyKarolinska InstitutetKarolinska University HospitalStockholmSweden Department of Surgery Amsterdam UMCUniversity of AmsterdamAmsterdamThe Netherlands

A two-stage liver resection is a surgical option in patients with bilobar liver tumors in whom a single procedure is not feasible because of insufficient functional volume of the future liver *** use of unilateral portal vein occlusion,such as portal vein embolization,induce hypertrophy of the future liver remnant in order to enable subsequent *** enhancement of tumor growth along with the hypertrophy response has raised concerns regarding oncological outcomes of the procedure.

关键词： occlusion portal partition

The potential use of extended criteria donors and eligible recipients in liver transplantation for unresectable colorectal liver metastases in Central Sweden

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Hepatobiliary Surgery and Nutrition 2021年第4期10卷 476-485,I0001页

作者： Christina Villard Joakim Westman Jonas Frank Oystein Jynge ernesto sparrelid Carl Jorns Department of Cancer Division of Upper GIKarolinska University HospitalStockholmSweden Karolinska Institutet StockholmSweden Department of Transplantation Surgery Karolinska University HospitalStockholmSweden Department of Clinical Science Intervention and TechnologyKarolinska InstitutetStockholmSweden

Background:Unresectable colorectal liver metastases(CRLM)is a condition with poor prognosis.A recent treatment alternative improving survival in patients with unresectable CRLM,has emerged with the introduction of liver transplantation(LT),yet not uncontroversial with the current organ *** study aimed to retrospectively investigate the potential of declined donors with acceptable risk as liver graft donors and patients with unresectable CRLM as potential ***:All declined donors in central Sweden and all patients with CRLM discussed at multidisciplinary team conference at Karolinska University Hospital,January 2013-October 2018,were *** were classified according to the European Committee Guide to the quality and safety of organs for transplantation and potential recipients were evaluated by selection criteria,based on studies on the Norwegian Secondary Cancer study ***:Out of 1,462 evaluated potential donors,62(2.7 pmp)donors were identified,corresponding to 6-18%of the utilized donor *** of 1,008 included patients with CRLM,25(2.1 pmp)potential recipients were *** for LT and left-sided colon cancer were favorable prognostic ***:Today’s donor pool could increase with the use of extended criteria donors,which is sufficient and display an acceptable risk-benefit ratio for patients with unresectable *** current selection criteria a small subset of patients with unresectable CRLM are eligible *** subset of patients has a better survival compared to patients ineligible for LT.

关键词： Colorectal cancer(CRC) extended criteria donor unresectable colorectal liver metastases(unresectable CRLM) liver transplantation(LT)

How should liver hypertrophy be stimulated?A comparison of upfront associating liver partition and portal vein ligation for staged hepatectomy(ALPPS)and portal vein embolization(PVE)with rescue possibility

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Hepatobiliary Surgery and Nutrition 2021年第1期10卷 1-8页

作者： ernesto sparrelid Kristina Hasselgren Bård Ingvald Røsok Peter Nørgaard Larsen Nicolai Aagaard Schultz Ulrik Carling Eva Fallentin Stefan Gilg Per Sandström Gert Lindell Bergthor Björnsson Department of Clinical Science Intervention and TechnologyDivision of SurgeryKarolinska InstituteKarolinska University HospitalStockholmSweden Department of Surgery and Clinical and Experimental Medicine Linköping UniversityLinköpingSweden Department of Hepato-Pancreato-Biliary Surgery Oslo University HospitalOsloNorway Department of Surgical Gastroenterology and Transplantation RigshospitaletUniversity of CopenhagenDenmark Department of Radiology and Nuclear Medicin RikshospitaletOslo University HospitalOsloNorway Department of Radiology RigshospitaletUniversity of CopenhagenCopenhagenDenmark Department of Surgery Skane University HospitalLundSweden

Background:The role of associating liver partition and portal vein ligation for staged hepatectomy(ALPPS)in comparison to portal vein embolization(PVE)is *** aim of this study was to compare successful resection rates(RR)with upfront ALPPS *** with rescue ALPPS on demand and to compare the hypertrophy of the liver between ALPPS and PVE plus subsequent rescue ***:A retrospective analysis of all patients treated with PVE for colorectal liver metastasis(CRLM)or ALPPS(any diagnosis,rescue ALPPS included)at five Scandinavian university hospitals during the years 2013-2016 was conducted.A Chi-square test and a Mann-Whitney U test were used to assess the difference between the groups.A successful RR was defined as liver resection without a 90-day ***:A total of 189 patients were *** RR was in 84.5%of the patients with ALPPS upfront and in 73.3%of the patients with PVE and rescue ALPPS on demand(P=0.080).The hypertrophy of the future liver remnants(FLRs)with ALPPS upfront was 71%(48-97%)compared to 96%(82-113%)after PVE and rescue ALPPS(P=0.010).Conclusions:Upfront ALPPS offers a somewhat higher successful RR than PVE with rescue ALPPS on *** sequential combination of PVE and ALPPS leads to a higher overall degree of hypertrophy than upfront ALPPS.

关键词： Associating liver partition and portal vein ligation for staged hepatectomy(ALPPS) liver surgery colorectal liver metastases(CRLM) portal vein embolization(PVE)

Arterial ischemia in the deportalized liver following associating liver partition and portal vein ligation for staged hepatectomy

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世界肝病学杂志：英文版（电子版） 2015年第23期7卷 2492-2496页

作者： Srinivas Sanjeevi ernesto sparrelid Stefan Gilg Eduard Jonas Bengt Isaksson Department of Surgical Gastroenterology Karolinska University Hospital Division of Surgery Department of Clinical Science Intervention and Technology (CLINTEC) Karolinska Institutet

Associating liver partition and portal vein ligation for staged hepatectomy(ALPPS) is a novel 2-stage technique intended to induce rapid growth of the future liver remnant(FLR). Initial reports of a 12% mortality rate have sparked debate regarding the safety of the procedure. A 64 years old male was planned for a rightsided hemi-hepatectomy due to colorectal cancer liver metastases. Intra-operatively it was decided to convert to an ALPPS due to unexpectedly small segments 2-4. Post-operative serum laboratory tests indicated an acute liver failure and radiological imaging showed no sign of arterial blood flow to the right hemi-liver. A computed tomography examination on post-operative day 3 revealed that the FLR had increased from 290 to 690 m L in 3 d(138% growth). In the following days serum values gradually improved and stage 2 was carried out on post-operative day 7. The rest of the hospital stay was uneventful and the patient made a full recovery. ALPPS is a fascinating advancement in liver surgery. Despite severe post-operative complications, in properly selected cases it provides successful outcomes that other modalities of treatment cannot offer.

关键词： Associating liver partition and portal vein ligati