Feasibility and safety of ALPPS procedure: our experience

Background The associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is a surgical strategy for patients with advanced liver tumors and inadequate future liver remnants (FLR). This study compares post-operative outcomes between open (oALPPS) and robotic (rALPPS) ALPPS in our institution. Methods This retrospective monocentric study includes eleven patients who underwent ALPPS procedure between January 2023 and February 2024. Demographics, tumor characteristics, and intra- and post-operative outcomes were collected and analyzed. Results In the first-stage ALPPS, the frequency of intermittent hilum clamp and the estimated blood loss were higher in the oALPPS group, while operative time and complications were similar, and total hospital stay was higher in the rALPPS group. In the second-stage ALPPS, the data regarding intraoperative and post-operative data were similar. In rALPPS, there were no post-discharge complications, readmissions, or deaths within 30 days. Conclusion This single-center study has an exploratory setting given the small cohort, but if confirmed in larger studies, rALPPS could be a viable alternative to oALPPS.