ALPPS – Associating Liver Partition & Portal Vein Ligation for Staged Hepatectomy

Typically referred to as an ALPPS procedure, an associating liver partition and portal vein ligation for staged hepatectomy is one of today’s most advanced treatments for liver cancer and metastasis to the liver from cancers originating in other organs (e.g., colon or rectal cancer). Because the liver is capable of regenerating itself, it may be possible for a surgeon to remove part of the organ when treating liver tumors, provided that enough liver tissue can be left in place. However, when liver tumors have spread extensively throughout the organ or when there are multiple tumors, it can be difficult for a surgeon to preserve adequate amounts of the patient’s original liver tissue. In these instances, a surgeon may recommend the ALPPS technique, which promotes rapid regrowth of the liver, in turn increasing the surgeon’s ability to remove all cancerous tissues from the organ.

An associating liver partition and portal vein ligation for staged hepatectomy is actually performed as two separate surgeries as follows:

  • During the first portion of an ALPPS procedure, a surgeon blocks off a branch of the portal vein (the main vein that delivers blood to the liver). This makes the liver behave as though part of the organ has been removed, triggering the process of tissue regeneration on the other side. Small surface tumors may be removed during this part of the operation as well. Additionally, a cut on the liver is performed which delineates what the future resection line will be and induces faster and more significant growth of the portion of the liver that will remain.
  • During the second part of an ALPPS procedure, and after performing 3D reconstruction and volumetric analysis to ensure the liver has regenerated enough, roughly one to two weeks after the first operation, a surgeon performs a liver resection, removing the diseased portion of the liver. The remaining part of the liver, which by this point has grown significantly, will be able to compensate and provide all the necessary functions of the liver.

Moffitt Cancer Center has one of the most robust liver tumor programs in the nation, offering advanced treatments such as ALPPS, and modified approaches that make this procedure an even safer, but equally effective, surgery. This has resulted in improved patient outcomes and quality of life. Furthermore, because our surgeons work hand-in-hand with other professionals (such as our medical oncologists, radiation oncologists and interventional radiologists), we are able to create comprehensive treatment plans that incorporate the most promising treatments for a specific patient.

To learn more about the ALPPS technique or any of the other procedures performed for liver cancer treatment at Moffitt Cancer Center, call 1-888-663-3488 or submit a new patient registration form online. Referrals are welcome, but never required.