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Too Many Languages in the ALPPS: Preventing Another Tower of Babel?
Michael Linecker1, Philipp Kron, Hauke Lang
1*Swiss HPB and Transplantation Center, Department of Surgery, University Hospital Zurich, Zurich, Switzerland †Department of General Surgery and Transplantation, University Hospital Mainz, Mainz, Germany ‡Department of Surgery, Division of HPB Surgery, Liver Transplant Unit, Italian Hospital Buenos Aires, Buenos Aires, Argentina §Centre Hépato-Biliaire, Hôpital Paul Brousse, University Paris Sud, Villejuif, France.
Objectives:
To establish a "consensus" terminology of many variants of the ALPPS procedure.
Backround:
The rapid development and dissemination of ALPPS with the availability of many variants has led to numerous neologisms, also leading to confusion and difficulties in comparing various experiences. The first expert meeting in February 2015 in Hamburg concluded that the development of a common terminology of procedures, summarized under the acronym ALPPS, is needed.
Methods:
The current literature on ALPPS and the International ALPPS registry, including more than 600 cases, were reviewed to identify all the acronyms related to ALPPS. A logical nomenclature system was proposed by founding members of the registry and subsequently submitted to each center registered in the ALPPS registry (n = 209) to reach a consensus.
Results:
The many identified ALPPS terms were classified according to their application (e.g. surgical access such as laparoscopy, transection variants etc.). These variants were subsequently placed in form of prepositions before ALPPS following a defined order: strategy, stage of the procedure, access, portal vein embolization, if used, types of transection and hepatectomy. The principles for the terminology and specific application were eventually commented and approved by each center registered in the registry.
Conclusions:
The proposed "consensus" terminology should enable to better compare the many variants of ALPPS, and was also designed to implement future developments due to the readily applicable principles.
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