Abstract:Postoperative liver failure has always been a difficult issue for liver surgeons, which is often directly related to the small volume of future liver remnant (FLR). The associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is an innovative technique for rapid growth of FLR in a short period of time, which brings hope to those who cannot withstand a radical surgery because of insufficient volume of FLR. However, after the high postoperative mortality rates of ALPPS reported by many large medical centers, how to correctly grasp the indications of ALPPS and improve the traditional ALPPS becomes particularly important. Here, the authors address the mechanism of ALPPS promoting FLR hyperplasia, the case selection for ALPPS, the controversies regarding ALPPS and the latest progress of the derivative procedures based on the classical ALPPS.