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Using ALPPS for the the treatment of hepatocellular carcinoma.

Using radiofrequency ablation instead of in-situ split of liver in ALPPS stage I（RALPPS）.Habib 4X was used in RFA.

Using radiofrequency ablation assisted ALPPS（RALPPS）instead of in-situ split of liver to form a coagulation band in stage I.Habib 4X was used in RFA.

RALPPS

Treat the hepatocellular carcinoma with ALPPS.

ALPPS

Jun Yan, Ph.D

Kuansheng Ma, Ph.D

Currently，the "ALPPS" (associating liver partition with portal vein ligation for staged hepatectomy) procedure which enables the rapid growth of the future liver remnant and extends surgical indication to patients with mid-advanced stage hepatocellular carcinoma becomes a research hot spot. However, the procedure has a high morbidity and mortality rate.Using radio-frequency ablation instead of in-situ split of liver to avoid forming a coagulation band in stage I will reduce the incidence of complications（bile leakage, abdominal infection,hemorrhage e.t.) The investigators named this technique as Radio-frequency Assisted Liver Partition with Portal vein ligation for staged hepatectomy （RALPPS）.Investigators hypothesized that the RALPPS might result in lower morbidity and mortality rate than ALPPS in the treatment of hepatocellular carcinoma . This Prospective Randomized Controlled Trial is on the Safety and Efficacy of radio-frequency assisted liver partition with portal vein ligation for staged hepatectomy for hepatocellular carcinoma.

RALPPS Venus ALPPS for Hepatocellular Carcinoma

A Prospective Randomized Controlled Trial of Radio-frequency Assisted ALPPS（RALPPS）and Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy（ALPPS）in the Treatment of Hepatocellular Carcinoma.

complications include bile leakage, abdominal infection, hemorrhage, PHLF e.t.

Southwest Hospital, China

institute of hepatobiliary surgery

Rare Diseases

Cholangiocarcinoma

Klatskin Tumor

Bile Duct Cancer

Intrahepatic Cholangiocarcinoma

Patients with initial volume of FLR \< 40% which underwent RALPPS and major liver resection (as the second stage of RALPPS) for hilar and intrahepatic cholangiocarcinoma

Patients with initial volume of FLR \< 40% undergoing PVE and major liver resection for hilar and intrahepatic cholangiocarcinoma

RALPPS: split-in-situ resection with radio-frequency ablation (RFA) instead of liver partition on the first stage and major liver resection on the second stage

PVE on the first stage and major liver resection on the second stage

portal vein embolization + major liver resection

Mikhail Efanov

Unsatisfactory immediate outcomes of Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) in surgery of cholangiocarcinoma suggested that patients with biliary cancer should not be treated by ALPPS. Short-term results of ALPPS variants with reduced surgical trauma on the first stage in patients with cholangiocarcinoma were not yet estimated. The objective of the study was estimation of the short-term results of split-in-situ resection with radio-frequency ablation (RFA) instead of liver partition on the first stage (RALPPS) in patients with hilar (h-CCA) and intrahepatic (i-CCA) cholangiocarcinoma compared with portal vein embolization (PVE).

ALPPS has been recently proposed as the most effective method to induce marked and rapid hypertrophy of FLR with 95-100% completion rate of the second stage. The most common indication for ALPPS is locally advanced multiple colorectal liver metastases. Unsatisfactory immediate outcomes of ALPPS in surgery of cholangiocarcinoma (CCA) including high mortality reached 48% in patients with h-CCA suggested that patients with biliary cancer should not be treated by ALPPS.

Recently reported modifications of in situ splitting (partial ALPPS, RALPPS (radio-frequency-assisted liver partition with portal vein ligation for staged hepatectomy) and ALTPS (associating liver tourniquet and right portal vein ligation for staged hepatectomy) etc) have been aimed to minimize the operating injury on the first stage, hereby reducing postoperative morbidity.

The other important idea was to preserve all initial benefits of ALPPS in terms of liver hypertrophy and completeness of the second stage. To date, there is no evidence of the benefits of any new ALPPS modification over others in reducing the morbidity of procedure, particularly in patients with CCA..

RALPPS in Patients With Hilar and Intrahepatic Cholangiocarcinoma

Split-in-situ Resection With Radio-frequency Ablation Instead of Liver Partition on the First Stage (RALPPS) in Patients With Hilar and Intrahepatic Cholangiocarcinoma

Degree of FLR enlargement (%) with respect to initial volume of FLR \[(Post-PVE FLR - Pre-PVE FLR) / (Pre-PVE FLR)\] x 100

Grade \> II according to Clavien-Dindo classification

Blood loss during second stage (major liver resection)

Liver failure after the second stage according to criteria of International Study Group of Liver Surgery

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
RALPPS Venus ALPPS for Hepatocellular Carcinoma	NCT02299843	Hepatocellular ...	RALPPS ALPPS	18 Years - 70 Years	Southwest Hospital, China
RALPPS Venus ALPPS for Hepatocellular Carcinoma	NCT02299843	Hepatocellular ...	RALPPS ALPPS	18 Years - 70 Years	Southwest Hospital, China
RALPPS in Patients With Hilar and Intrahepatic Cholangiocarcinoma	NCT03320980	Hilar Cholangio... Intrahepatic Ch...	RALPPS portal vein emb...	18 Years - 80 Years	Moscow Clinical Scientific Center
RALPPS in Patients With Hilar and Intrahepatic Cholangiocarcinoma	NCT03320980	Hilar Cholangio... Intrahepatic Ch...	RALPPS portal vein emb...	18 Years - 80 Years	Moscow Clinical Scientific Center

Spots Global Cancer Trial Database for ralpps

Every month we try and update this database with for ralpps cancer trials from around the world to help patients and their families find trials that might be right for them.
We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.

Spots Global Cancer Trial Database for ralpps

Every month we try and update this database with for ralpps cancer trials from around the world to help patients and their families find trials that might be right for them. We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.

Every month we try and update this database with for ralpps cancer trials from around the world to help patients and their families find trials that might be right for them.
We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.