{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T03:43:47Z","timestamp":1787629427884,"version":"build-2736575974"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,2,21]],"date-time":"2021-02-21T00:00:00Z","timestamp":1613865600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,2,21]],"date-time":"2021-02-21T00:00:00Z","timestamp":1613865600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World J Surg Onc"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>The associating liver partitioning and portal vein occlusion for staged hepatectomy (ALPPS) procedure is gaining interest because it brings hope to patients who cannot undergo radical surgical resection due to insufficient remnant liver volume. However, the indications and technical aspects of this procedure are still under debate. This report demonstrates the technical aspects of the first two-stage robotic ALPPS for HCC.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 55-year-old man with type II portal vein variation was diagnosed with hepatocellular carcinoma. Preoperative 3D reconstruction of the liver based on CT showed a future liver remnant\/standard liver volume (FLR\/SLV) of 24.45%. The ALPPS procedure was performed using the da Vinci Si system. At the first stage of the operation, we removed the gallbladder and ligated the right anterior branch of the portal vein and the right posterior branch. Following blocking of the hepatic hilum, the liver parenchyma was removed 1\u2009cm away from the right side of the falciform ligament in an incision manner from the top to the bottom and from shallow to deep. The second-stage operation was performed on the 12th postoperative day with a FLR\/SLV of 45.13%. During this step, the right hemiliver plus left medial section was separated and removed. Postoperative pathology showed a negative margin. The operative times were 195 and 217\u2009min, respectively. Estimated blood loss was 250 and 500\u2009ml, respectively. There was no need for transfusion or hospitalization in intensive care. The patient was discharged on the 6th postoperative day. Recovery was uneventful after both stages, and the patient did not present any sign of liver failure. Elevation of liver enzymes was minimal. The patient had no evidence of the disease 14\u2009months after the procedure.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The two-stage robotic ALPPS procedure is a safe and feasible technique for select patients with HCC.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12957-021-02170-0","type":"journal-article","created":{"date-parts":[[2021,2,21]],"date-time":"2021-02-21T13:02:39Z","timestamp":1613912559000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["First two-stage robotic ALPPS in HCC patients with hepatic vein invasion: a step-by-step procedure from a clinical case"],"prefix":"10.1186","volume":"19","author":[{"given":"Ming-Gen","family":"Hu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhu-Zeng","family":"Yin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rong","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,2,21]]},"reference":[{"key":"2170_CR1","doi-asserted-by":"publisher","first-page":"829","DOI":"10.1097\/SLA.0000000000000947","volume":"260","author":"E Schadde","year":"2014","unstructured":"Schadde E, Ardiles V, Robles-Campos R, ALPePS Registry Group, et al. Early survival and safety of ALPPS: first report of the International ALPPS Registry. Ann Surg. 2014;260:829\u201336.","journal-title":"Ann Surg"},{"key":"2170_CR2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e318265ff2e","volume":"256","author":"MA Machado","year":"2012","unstructured":"Machado MA, Makdissi FF, Surjan RC. Totally laparoscopic ALPPS is feasible and may be worthwhile. Ann Surg. 2012;256:e13.","journal-title":"Ann Surg"},{"issue":"9","key":"2170_CR3","doi-asserted-by":"publisher","first-page":"2800","DOI":"10.1007\/s00464-014-4000-1","volume":"29","author":"L Xiao","year":"2015","unstructured":"Xiao L, Li JW, Zheng SG. Totally laparoscopic ALPPS in the treatment of cirrhotic hepatocellular carcinoma. Surg Endosc. 2015;29(9):2800\u20131.","journal-title":"Surg Endosc"},{"issue":"4","key":"2170_CR4","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1016\/j.suronc.2015.10.001","volume":"25","author":"E Vicente","year":"2016","unstructured":"Vicente E, Quijano Y, Ielpo B, Fabra I. First ALPPS procedure using a total robotic approach. Surg Oncol. 2016;25(4):457.","journal-title":"Surg Oncol"},{"key":"2170_CR5","doi-asserted-by":"crossref","unstructured":"Lang H, de Santiba\u00f1es E, Schlitt HJ, et al. 10th Anniversary of ALPPS\u2014lessons learned and quo vadis. Ann Surg. 2019;269(1):114\u20139.","DOI":"10.1097\/SLA.0000000000002797"},{"key":"2170_CR6","doi-asserted-by":"publisher","first-page":"691","DOI":"10.1016\/j.surg.2017.09.044","volume":"163","author":"KN Wanis","year":"2018","unstructured":"Wanis KN, Ardiles V, Alvarez FA, et al. 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;163:691\u20137.","journal-title":"Surgery."},{"key":"2170_CR7","doi-asserted-by":"publisher","first-page":"e14","DOI":"10.1097\/SLA.0000000000001272","volume":"263","author":"AC Chan","year":"2016","unstructured":"Chan AC, Poon RT, Chan C, et al. Safety of ALPPS procedure by the anterior approach for hepatocellular carcinoma. Ann Surg. 2016;263:e14\u20136.","journal-title":"Ann Surg"},{"key":"2170_CR8","doi-asserted-by":"publisher","first-page":"780","DOI":"10.1097\/SLA.0000000000001450","volume":"262","author":"E Schadde","year":"2015","unstructured":"Schadde E, Raptis DA, Schnitzbauer AA, et al. Prediction of mortality after ALPPS stage-1: an analysis of 320 patients from the international ALPPS registry. 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