Present and future for associating liver partition and portal vein ligation for staged hepatectomy

Compared to portal vein embolization and traditional two stage hepatectomy, associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) can induce the proliferation of liver rapidly, concomitantly with high incidence of complications and mortality in the perioperative period. The feasibility and safety have been improved gradually as the improvement of technology and the accumulation of experience. But it is still controversial on its efficacy for malignant tumors, especially with insufficiency of medium and long term outcomes. The mechanism of rapid proliferation induced by ALPPS needs more studies with further steps.