[Experience of two-staged liver resection (ALPPS)]

The aim was to estimate single center results of ALPPS. It was performed 5 ALPPS-procedures in our center during the period from February 2013 to March 2014. There were 1 female and 4 males in the age of 58-64 years. The indications for surgery were colorectal cancer metastases in 4 cases, bladder cancer metastases in 1 observation. The operations included 3 right-sided hemihepatectomies, 2 extended right-sided hemihepatectomies. In 3 cases operations were accompanied by additional atypical resection of residuary liver lobe. In 2 observations unsuccessful embolization of the portal vein was done. The waiting time between procedures consisted 18 days in the first case and 6 days in other cases. Final hepatectomy was performed in all observations. Hypertrophy of left liver lobe was more than 50% in all cases. Postoperative complications happened in 3 out of 5 cases. One patient died because of progressive thrombosis of inferior vena cava and developed multiorgan failure. There were 1 complication of level 2 and 1 complication of level 4a according to Dindo-Clavien classification. One patient had biliary fistula after final hepatectomy. It wasn't observed cases of severe liver failure. ALPPS is appropriate method for fast residuary liver lobe hypertrophy. It allows to perform R0-resection of liver but ALPPS has high postoperative complication rate.