COMMENTARY Are We Thinking? A Commentary on “Is Partial-ALPPS Safer Than ALPPS? A Single-center Experience”
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ince the initial report describing a strategy for liver resection1 commonly known as ALPPS (associating liver partition with portal vein ligation for staged hepatectomy), the procedure has stimulated fervent debate among hepatopancreatobiliary surgeons worldwide. While some passionately champion the procedures as a major breakthrough in liver surgery,2 others argue with equal passion that ALPPS represents an approach without proven benefit over percutaneous portal vein embolization or 2-stage hepatectomy with portal vein ligation without liver partition.3 The debate is fueled, in part, by initial reports of ALPPS citing relatively high rates of morbidity and mortality. Better patient selection has been proposed as a strategy to improve safety and efficacy of ALPPS. Younger patient (
S
ince the initial report describing a strategy for liver resection1 commonly known as ALPPS (associating liver partition with portal vein ligation for staged hepatectomy), the procedure has stimulated fervent debate among hepatopancreatobiliary surgeons worldwide. While some passionately champion the procedures as a major breakthrough in liver surgery,2 others argue with equal passion that ALPPS represents an approach without proven benefit over percutaneous portal vein embolization or 2-stage hepatectomy with portal vein ligation without liver partition.3 The debate is fueled, in part, by initial reports of ALPPS citing relatively high rates of morbidity and mortality. Better patient selection has been proposed as a strategy to improve safety and efficacy of ALPPS. Younger patient (
