From PVE to HVE to fully laparoscopic rescue ALPPS: a case report of multidisciplinary management of giant HCC

Different strategies have been used to induce preoperative liver hypertrophy and reduce the risk of postoperative liver failure. Those have included both radiological-interventional and surgical strategies, such as portal and hepatic vein embolization, 2-stage hepatectomy and associated liver partition with portal vein ligation for staged hepatectomy (ALPPS). Herein, we describe the case of a patient with a large right liver hepatocellular carcinoma not amenable to liver transplantation, with HBV-related chronic hepatitis and a small future liver remnant (FLR), who underwent a multistep approach to ensure a safe major laparoscopic resection with an adequate FLR.