Two-Stage Extended Liver Resection (TAMLAPS) is a complex surgical procedure designed for patients with extensive liver tumors that cannot be removed in a single operation. This technique allows the liver to regenerate between two separate surgeries, ensuring enough healthy liver remains after tumor removal. It is commonly used for patients with bilobar liver metastases or large hepatocellular carcinoma (HCC).
This procedure is recommended for patients with:
Extensive liver tumors that involve both lobes.
Bilobar colorectal liver metastases where multiple tumors are present in different liver regions.
Primary liver cancer (HCC) or intrahepatic cholangiocarcinoma requiring major liver resection.
Insufficient future liver remnant (FLR) – When removing the tumor in one step would leave too little liver for survival.
Preoperative Assessment – Imaging (CT/MRI) and liver function tests determine surgical feasibility.
Partial Tumor Removal – The surgeon removes smaller, less complex tumors.
Portal Vein Ligation (PVL) or Embolization (PVE) – Blood flow to the diseased liver section is blocked, directing it to the healthy portion to stimulate regeneration.
Recovery & Liver Regeneration – The patient waits 4-6 weeks for the healthy liver to grow before the second surgery.
Evaluation of Liver Regeneration – Imaging confirms if the liver has grown sufficiently.
Extended Liver Resection – The remaining large tumors are surgically removed while preserving the newly grown liver.
Final Reconstruction & Closure – The surgical area is closed, and recovery begins.
Enables complete tumor removal in cases where a single-stage resection is not feasible.
Allows liver regeneration, reducing the risk of liver failure.
Improves survival rates for patients with complex liver tumors.
Offers an alternative to non-resectable liver cancers, providing a curative approach.
Hospital stay of 7-14 days for each stage.
Monitoring of liver function and regeneration between surgeries.
Gradual return to normal activities over several weeks post-surgery.
Follow-up imaging and blood tests to assess liver function and detect recurrence.
While effective, TAMLAPS carries some risks, including:
Liver failure if regeneration is insufficient.
Bleeding and infection at the surgical site.
Delayed liver regeneration, prolonging the waiting period between stages.
Risk of tumor progression during the interval between surgeries.
Two-Stage Extended Liver Resection (TAMLAPS) is a lifesaving surgical approach for patients with advanced, multi-lobar liver tumors, allowing for complete tumor removal while preserving liver function. If you have extensive liver cancer or metastases, consult your specialist to determine if TAMLAPS is the right treatment option for you.