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J Vis Exp. 2017 Aug 14;(126). doi: 10.3791/55895.

Rat Model of the Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy (ALPPS) Procedure.

Author information

1
Institute of Physiology - Center for Integrative Human Physiology, University of Zurich; Department of Surgery, Rush University Medical Center; Department of Surgery, Cantonal Hospital Winterthur; erik.schadde@uzh.ch.
2
Department of Surgery, Rush University Medical Center.
3
Department of Surgery, Cantonal Hospital Winterthur.
4
Institute of Physiology - Center for Integrative Human Physiology, University of Zurich; Institute of Anesthesiology, University and University Hospital Zurich.

Abstract

Recent clinical data support an aggressive surgical approach to both primary and metastatic liver tumors. For some indications, like colorectal liver metastases, the amount of liver tissue left behind after liver resection has become the main limiting factor of resectability of large or multiple liver tumors. A minimal amount of functional tissue is required to avoid the severe complication of post-hepatectomy liver failure, which has high morbidity and mortality. Inducing liver growth of the prospective remnant prior to resection has become more established in liver surgery, either in the form of portal vein embolization by interventional radiologists or in the form of portal vein ligation several weeks prior to resection. Recently, it was shown that liver regeneration is more extensive and rapid, when the parenchymal transection is added to portal vein ligation in a first stage and then, after only one week of waiting, resection performed in a second stage (Associating Liver Partition and Portal vein ligation for Staged hepatectomy = ALPPS). ALPPS has rapidly become popular across the world, but has been criticized for its high perioperative mortality. The mechanism of accelerated and extensive growth induced by this procedure has not been well understood. Animal models have been developed to explore both the physiological and molecular mechanisms of accelerated liver regeneration in ALPPS. This protocol presents a rat model that allows mechanistic exploration of accelerated regeneration.

PMID:
28829432
PMCID:
PMC5614312
[Available on 2019-08-14]
DOI:
10.3791/55895
[Indexed for MEDLINE]

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