Q) ALPSS all are true except?
✅ Answer: a) ALPPS should be considered in every patient in whom PVE or the classic two-stage approach is not feasible or has failed.
🔍 Explanation:
The limits for safe hepatic resections are usually considered from 20% to 40%, depending on the quality of liver parenchyma (fibrosis, steatosis, chemotherapy-related liver injury).
The lower limit for FLRV is set at 20% in patients with normal livers, 30% to 35% in patients with chemotherapy-related liver injury, and 40% in patients with chronic liver disease.
Cut-off values for proceeding to stage 2, usually after 7 to 14 days, are sFLR greater than 30% (BWR > 0.5%) or 40% (BWR > 0.8%) depending on parenchymal quality. (Ref BG page 1665)
Currently, CRLM is the most promising indication, especially for bilobar involvement.
In hilar cholangiocarcinoma, it is a relative contraindication as the mortality and morbidity are high.
🔍 Explanation:
The limits for safe hepatic resections are usually considered from 20% to 40%, depending on the quality of liver parenchyma (fibrosis, steatosis, chemotherapy-related liver injury).
The lower limit for FLRV is set at 20% in patients with normal livers, 30% to 35% in patients with chemotherapy-related liver injury, and 40% in patients with chronic liver disease.
Cut-off values for proceeding to stage 2, usually after 7 to 14 days, are sFLR greater than 30% (BWR > 0.5%) or 40% (BWR > 0.8%) depending on parenchymal quality. (Ref BG page 1665)
Currently, CRLM is the most promising indication, especially for bilobar involvement.
In hilar cholangiocarcinoma, it is a relative contraindication as the mortality and morbidity are high.