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Considerable efforts have been made to overcome this initial unresectability, including expanding the indication of surgery, the advent of conversion chemotherapy, and development and modification of specific surgical techniques, regulated under multidisciplinary approaches. In terms of specific surgical techniques, portal vein ligation\/embolization can increase the volume of future liver remnant and thereby reduce the risk of hepatic insufficiency and death after major hepatectomy. For multiple bilobar <jats:styled-content style=\"fixed-case\">CRLM<\/jats:styled-content> that were traditionally considered unresectable even with preoperative chemotherapy and portal vein embolization, two\u2010stage hepatectomy was introduced and has been adopted worldwide with acceptable short\u2010 and long\u2010term outcomes. Recently, <jats:styled-content style=\"fixed-case\">ALPPS<\/jats:styled-content> (associating liver partition and portal vein ligation for staged hepatectomy) was reported as a novel variant of two\u2010stage hepatectomy. Although issues regarding safety remain unresolved, rapid future liver remnant hypertrophy and subsequent shorter intervals between the two stages lead to a higher feasibility rate, reaching 98%. In addition, adding radiofrequency ablation and vascular resection and reconstruction techniques can allow expansion of the pool of patients with <jats:styled-content style=\"fixed-case\">CRLM<\/jats:styled-content> who are candidates for liver resection and thus a cure. In this review, we discuss specific techniques that may expand the criteria for resectability in patients with initially unresectable <jats:styled-content style=\"fixed-case\">CRLM<\/jats:styled-content>.<\/jats:p>","DOI":"10.1002\/ags3.12276","type":"journal-article","created":{"date-parts":[[2019,7,11]],"date-time":"2019-07-11T13:32:28Z","timestamp":1562851948000},"page":"476-486","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":65,"title":["How to increase the resectability of initially unresectable colorectal liver metastases: A surgical perspective"],"prefix":"10.1002","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0549-1825","authenticated-orcid":false,"given":"Katsunori","family":"Imai","sequence":"first","affiliation":[{"name":"Department of Gastroenterological Surgery Graduate School of Life Sciences Kumamoto University Kumamoto 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