Associating liver partition and portal vein ligation for staged hepatectomy combined with mixed reality holographic imaging in treating massive hepatocellular carcinoma: a case report_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHANG Longxin , CHEN Xiaoxin , JIANG Kaiwen ,  WANG Wei

Department Ⅱ of Surgery, Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou 510185, P. R. China;

Corresponding author：

WANG Wei, Email: wwsir8@163.com

Keywords：

partial hepatectomy; mixed reality holographic imaging; massive hepatocellular carcinoma; future liver reserve

DOI：

10.7507/1007-9424.202002067

Video：

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Objective To investigate the feasibility of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) combined with mixed reality holographic imaging in treating the massive hepatocellular carcinoma.Method The clinicopathologic data of 1 patient with massive hepatocellular carcinoma underwent the ALPPS combined with mixed reality holographic imaging in the Guangdong Second Traditional Chinese Medicine Hospital on January 2019 were retrospectively analyzed.Results A 58-year-old female patient, the preoperative CT scan and enhanced scan of the abdomen revealed a 12.0 cm×10.5 cm×17.0 cm mass in the right lobe of the liver, with preoperative Child-Pugh grade A liver function. The ALPPS was performed after the preoperative evaluation. The associating liver partition and portal vein ligation was performed and the mixed reality holographic imaging was used during the stage Ⅰ operation. On day 21 after the stage Ⅰ operation, the CT results of the volume of left lateral lobe of liver was approximately 57.64%. On day 24 after the stage Ⅰ operation, the patient underwent the stage Ⅱ operation (radical hepatectomy). The patient received the chemotherapy after the operation. The courses of those operations were successful. And no severe complications occurred after the operation. The postoperative pathological results showed a moderately differentiated hepatocellular carcinoma with multiple foci and a maximum diameter of 13 cm. Six months after the last operation, there was no new intrahepatic metastasis and other metastases were found.Conclusions ALPPS combined with mixed reality holographic imaging is effective in treatment of massive hepatocellular carcinoma. Mixed reality holographic imaging could show anatomical details with three dimensions, it is beneficial for estimating future liver reserve before operation and locating during operation, and there is also a positive significance of postoperative recovery.

Citation： ZHANG Longxin, CHEN Xiaoxin, JIANG Kaiwen, WANG Wei. Associating liver partition and portal vein ligation for staged hepatectomy combined with mixed reality holographic imaging in treating massive hepatocellular carcinoma: a case report. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2020, 27(10): 1284-1289. doi: 10.7507/1007-9424.202002067 Copy

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2.	Gavriilidis P, Askari A, Azoulay D. Survival following redo hepatectomy vs radiofrequency ablation for recurrent hepato-cellular carcinoma: a systematic review and meta-analysis. HPB(Oxford), 2017, 19(1): 3-9.
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11.	Hashimoto T, Makuuchi M. Portal vein embolization versus associated liver partition and portal vein ligation for staged hepatectomy. Dig Surg, 2018, 35(4): 311-322.
12.	Edmondson MJ, Sodergren MH, Pucher PH, <italic>et al</italic>. Variations and adaptations of associated liver partition and portal vein ligation for staged hepatectomy (ALPPS): Many routes to the summit. Surgery, 2016, 159(4): 1058-1072.
13.	Lam VW, Laurence JM, Johnston E, <italic>et al</italic>. A systematic review of two-stage hepatectomy in patients with initially unresectable colorectal liver metastases. HPB (Oxford), 2013, 15(7): 483-491.
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15.	黄孝伦. ALPPS 术式的演变、方法与争议. 中国普外基础与临床杂志, 2016, 23(1): 5-8.
16.	Guglielmi A, Ruzzenente A, Conci S, <italic>et al</italic>. How much remnant is enough in liver resection? Dig Surg, 2012, 29(1): 6-17.
17.	Tucker ON, Heaton N. The ‘small for size’ liver syndrome. Curr Opin Crit Care, 2005, 11(2): 150-155.
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19.	Schlegel A, Lesurtel M, Melloul E, <italic>et al</italic>. ALPPS: from human to mice highlighting accelerated and novel mechanisms of liver regeneration. Ann Surg, 2014, 260(5): 839-846.
20.	Alvarez FA, Ardiles V, de Santibañes M, <italic>et al</italic>. Associating liver partition and portal vein ligation for staged hepatectomy offers high oncological feasibility with adequate patient safety: a prospective study at a single center. Ann Surg, 2015, 261(4): 723-732.
21.	Sala S, Ardiles V, Ulla M, <italic>et al</italic>. Our initial experience with ALPPS technique: encouraging results. Updates Surg, 2012, 64(3): 167-172.
22.	Alvarez FA, Ardiles V, Sanchez Claria R, <italic>et al</italic>. Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS): tips and tricks. J Gastrointest Surg, 2013, 17(4): 814-821.
23.	Torres OJ, Fernandes Ede S, Oliveira CV, <italic>et al</italic>. Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS): the Brazilian experience. Arq Bras Cir Dig, 2013, 26(1): 40-43.
24.	李想, 龚彩云, 丁江华, 等. 巨块型肝癌的治疗方式及临床疗效与卫生经济学分析. 解放军医院管理杂志, 2015, 22(10): 983-985.
25.	杨扬, 程张军, 周家华, 等. 联合肝脏离断和门静脉结扎的二步肝切除术治疗肝硬化巨大肝癌 2 例报告并文献复习. 中国普通外科杂志, 2016, 25(7): 965-972.

1. Zhong JH, Torzilli G, Xing H, <italic>et al</italic>. Controversies and evidence of hepatic resection for hepatocellular carcinoma. BBA Clin, 2016, 6: 125-130.
2. Gavriilidis P, Askari A, Azoulay D. Survival following redo hepatectomy vs radiofrequency ablation for recurrent hepato-cellular carcinoma: a systematic review and meta-analysis. HPB(Oxford), 2017, 19(1): 3-9.
3. Wanis KN, Ardiles V, Alvarez FA, <italic>et al</italic>. Intermediate-term survival and quality of life outcomes in patients with advanced colorectal liver metastases undergoing associating liver partition and portal vein ligation for staged hepatectomy. Surgery, 2018, 163(4): 691-697.
4. 中华人民共和国卫生和计划生育委员会医政医管局. 原发性肝癌诊疗规范(2017 年版). 中华消化外科杂志, 2017, 16(7): 635-647.
5. 王壮雄, 李林容, 王芳元, 等. 虚拟和增强现实技术在肝脏外科中的应用. 实用医学杂志, 2018, 34(7): 1210-1212.
6. 中华人民共和国国家卫生和计划生育委员会. 原发性肝癌诊疗规范(2017 年版). 临床肝胆病杂志, 2017, 33(8): 1419-1431.
7. Ma KW, Cheung TT. Surgical resection of localized hepatocellular carcinoma: patient selection and special consideration. J Hepatocell Carcinoma, 2016, 4: 1-9.
8. Liu C, Duan LG, Lu WS, <italic>et al</italic>. Prognosis evaluation in patients with hepatocellular carcinoma after hepatectomy: comparison of BCLC, TNM and Hangzhou criteria staging systems. PLoS One, 2014, 9(8): e103228.
9. 曹君, 陈亚进. 联合肝脏离断和门静脉结扎二步肝切除术几个焦点问题. 中国实用外科杂志, 2014, 34(8): 713-716.
10. Ferrero A, Viganò L, Polastri R, <italic>et al</italic>. Postoperative liver dysfunction and future remnant liver: where is the limit? Results of a prospective study. World J Surg, 2007, 31(8): 1643-1651.
11. Hashimoto T, Makuuchi M. Portal vein embolization versus associated liver partition and portal vein ligation for staged hepatectomy. Dig Surg, 2018, 35(4): 311-322.
12. Edmondson MJ, Sodergren MH, Pucher PH, <italic>et al</italic>. Variations and adaptations of associated liver partition and portal vein ligation for staged hepatectomy (ALPPS): Many routes to the summit. Surgery, 2016, 159(4): 1058-1072.
13. Lam VW, Laurence JM, Johnston E, <italic>et al</italic>. A systematic review of two-stage hepatectomy in patients with initially unresectable colorectal liver metastases. HPB (Oxford), 2013, 15(7): 483-491.
14. Schadde E, Schnitzbauer AA, Tschuor C, <italic>et al</italic>. Systematic review and meta-analysis of feasibility, safety, and efficacy of a novel procedure: associating liver partition and portal vein ligation for staged hepatectomy. Ann Surg Oncol, 2015, 22(9): 3109-3120.
15. 黄孝伦. ALPPS 术式的演变、方法与争议. 中国普外基础与临床杂志, 2016, 23(1): 5-8.
16. Guglielmi A, Ruzzenente A, Conci S, <italic>et al</italic>. How much remnant is enough in liver resection? Dig Surg, 2012, 29(1): 6-17.
17. Tucker ON, Heaton N. The ‘small for size’ liver syndrome. Curr Opin Crit Care, 2005, 11(2): 150-155.
18. Tashiro S. Mechanism of liver regeneration after liver resection and portal vein embolization (ligation) is different? J Hepatobiliary Pancreat Surg, 2009, 16(3): 292-299.
19. Schlegel A, Lesurtel M, Melloul E, <italic>et al</italic>. ALPPS: from human to mice highlighting accelerated and novel mechanisms of liver regeneration. Ann Surg, 2014, 260(5): 839-846.
20. Alvarez FA, Ardiles V, de Santibañes M, <italic>et al</italic>. Associating liver partition and portal vein ligation for staged hepatectomy offers high oncological feasibility with adequate patient safety: a prospective study at a single center. Ann Surg, 2015, 261(4): 723-732.
21. Sala S, Ardiles V, Ulla M, <italic>et al</italic>. Our initial experience with ALPPS technique: encouraging results. Updates Surg, 2012, 64(3): 167-172.
22. Alvarez FA, Ardiles V, Sanchez Claria R, <italic>et al</italic>. Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS): tips and tricks. J Gastrointest Surg, 2013, 17(4): 814-821.
23. Torres OJ, Fernandes Ede S, Oliveira CV, <italic>et al</italic>. Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS): the Brazilian experience. Arq Bras Cir Dig, 2013, 26(1): 40-43.
24. 李想, 龚彩云, 丁江华, 等. 巨块型肝癌的治疗方式及临床疗效与卫生经济学分析. 解放军医院管理杂志, 2015, 22(10): 983-985.
25. 杨扬, 程张军, 周家华, 等. 联合肝脏离断和门静脉结扎的二步肝切除术治疗肝硬化巨大肝癌 2 例报告并文献复习. 中国普通外科杂志, 2016, 25(7): 965-972.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Associating liver partition and portal vein ligation for staged hepatectomy combined with mixed reality holographic imaging in treating massive hepatocellular carcinoma: a case report

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