PMC4901504_01
Pre- and postoperative CT-scan of the liver. a Preoperative CT-scan depicting the tumor lesion within the right liver lobe (marked pink) and the resulting future liver remnant (FLR; marked purple). b CT-volumetry 7 days after the first step of ALPPS already resulted in a significant increase of the FLR. The extended right liver lobe (wrapped in a silicone matting) meanwhile showed signs of necrosis following ligation of the right portal vein. c CT-volumetry 11 days after the first step of ALPPS showed further growth of the FLR (marked red). POD = postoperative day
13037_2016_104_Fig1_HTML.jpg
PMC4901504_01_13037_2016_104_Fig1_HTML.jpg
Fig1
A CT-based volumetry on postoperative day (POD) 7 showed an increase of FLR volume to 519 cm3 representing approx. 30.8 % of the total liver volume with a FLR/BW ratio of 0.45 (Fig. 1).
Postoperative course of AST, Bilirubin and Quick value. Diagram depicting the courses of AST, Bilirubin and Quick value following the first and second step of the ALPPS-procedure, respectively. POD = postoperative day
13037_2016_104_Fig2_HTML.jpg
PMC4901504_01_13037_2016_104_Fig2_HTML.jpg
Fig2
The courses of these laboratory values are depicted in Fig. 2. ALPPS the patient showed a stable liver function throughout the entire postoperative course. AST and ALT levels were only slightly elevated (Fig. 2).
Postoperative course of FLR, LiMAx value and Quick value. Diagram depicting the courses of FLR, LiMAx value and Quick value following the first step of the ALPPS-procedure, respectively. POD = postoperative day
13037_2016_104_Fig3_HTML.jpg
PMC4901504_01_13037_2016_104_Fig3_HTML.jpg
Fig3
The latter now was found to be 371 mug/h/kg indicating sufficient growth and function of the FLR (Fig. 3).