LAUSR

The first evidence that portal vein deprivation associated with full parenchymal transection could lead to faster liver volume increase dates back to 2007. Later defined as associated liver partition and portal vein ligation for staged hepatectomy (ALLPS), this discovery offered hepatobiliary surgeons a valuable tool to manage cases of liver tumors with insufficient future liver remnant (FLR). Despite the initial enthusiasm, results were discouraging due to the high rates of morbidity and mortality. Later, it became evident that accurate patient selection could critically improve the outcomes of this novel technique; in particular, age younger than 65 years and exclusion of cases of perihilar cholangiocarcinoma (PHCC) were related to more favorable outcomes.