Liver resection is the gold standard treatment option for patients with primary or secondary liver tumours, providing them with the only chance for long-term survival. An extended hepatectomy is necessary in up to 45% cases to achieve a clear resection margin (1). Future liver remnant (FLR) must be at least 25% to 30% of the liver volume to overcome problems related to liver insufficiency in patients with a healthy liver. Only 10% to 20% of patients are suitable for surgery at presentation. Portal vein embolisation...

In-line radio frequency is used to create an virtual liver partition with portal vein ligation — Radiofrequency–Assisted Liver Partition with Portal vein ligation (RALPP). This can produce a precise avascular area up to 1 cm wide 5 patients (3 men, 2 women) with a median age of 62 years (range, 48–71 years) underwent RALPP by L.R.J All patients had a restaging computed tomographic scan with contrast to assess the liver volume before right hepatectomy Post-RALPP CT was performed at 2 weeks A historical cohort of...

RALPP could significantly increase the FLR by a median of 62.3% (range, 53.1%–95.4%) , which increased the FLR by a median of 24.6% (range, 8.4%–35.4%) This increase was achieved in a much shorter length of time (mean = 21.8 ± 9.4 days) than by PVE (55.4 ± 15.6 days) There was no difference in liver function between the 2 groups on days 1 to 5 posthepatectomy. No bile leaks were seen in patients on liver resection after RALPP.

Preliminary studies have demonstrated RALPP to be a feasible and safe alternative to ALPPS to achieve a rapid liver regeneration in the contralateral lobe of the liver without the increased morbidity and mortality associated with ALPPS. The 'REBIRTH' randomized controlledtrialhas now beenapproved to further evaluate whether RALPP is superior to PVE in the induction of liver hypertrophy at our centre.

1. Adam R, Avisar E, Ariche A, et al. Five-year survival following hepatic resection after neoadjuvant therapy for nonresectable colorectal. Ann Surg Oncol. 2001;8:347–353. 2. Abulkhir A, Limongelli P, Healey AJ, et al. Preoperative portal vein embolization for major liver resection: a meta-analysis. Ann Surg. 2008;247:49–57. 3. Schnitzbauer AA, Lang SA, Goessmann H, et al. Right portal vein ligation combined with in situ splitting induces rapid left lateral liver lobe hypertrophy enabling 2-staged extended right hepatic resection in small-for-size settings. Ann Surg. 2012;255:405–414. 4. Dello...