• Annals of surgery · Aug 2017

    Letter Case Reports

    Modified Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy for Hepatoblastoma in a Small Infant: How Far Can We Push the Envelope?

    • Johnny C Hong, Joohyun Kim, Meghen Browning, Amy Wagner, Stacee Lerret, Annette D Segura, and Michael A Zimmerman.
    • *Division of Transplant Surgery, Medical College of Wisconsin and Children's Hospital of Wisconsin, Milwaukee, WI †Division of Hematology, Oncology, Bone Marrow Transplant, Medical College of Wisconsin and Children's Hospital of Wisconsin, Milwaukee, WI ‡Division of Pediatric Surgery, Medical College of Wisconsin and Children's Hospital of Wisconsin, Milwaukee, WI §Division of Gastroenterology and Hepatology, Medical College of Wisconsin and Children's Hospital of Wisconsin, Milwaukee, WI ¶Division of Pediatric Pathology, Medical College of Wisconsin and Children's Hospital of Wisconsin, Milwaukee, WI.
    • Ann. Surg. 2017 Aug 1; 266 (2): e16-e17.

    Abstract: For patients with hepatoblastoma, a timely and complete resection of the tumor is critical to the patient's tumor recurrence-free survival. Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS), a 2-stage hepatectomy procedure, has revolutionized the surgical management of large hepatic tumors with insufficient future liver remnant (FLR) at presentation. Although existing data support the utility of ALPPS in adults with primary and metastatic hepatobiliary malignancy, the literature in children is scarce. To our knowledge, this is the first report showing clinical applicability and safety of the modified ALPPS procedure in a small infant (54 days old) with hepatoblastoma who presented with insufficient FLR. Our report suggests the modified ALPPS could potentially expand the surgical treatment alternative for small infants with large hepatoblastoma.

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