数字化技术在胰头癌手术中的应用研究

目的 探讨数字化技术在胰头癌手术中的应用价值。方法 收集10例胰头癌患者的临床资料。采用三维（3D）可视化技术观察血管的变异情况、胰头癌累及的范围、肿瘤与血管关系、胰周肿大淋巴结情况等,同时结合3D打印技术进行实时手术引导。分析术前规划结果、手术情况、手术前后肝功能及糖链抗原199（CA199）水平变化、术后并发症及近期疗效。结果 10例胰头癌患者均完成了基于数字化技术的术前规划及术中导航。所有患者均顺利完成手术。手术时间（315.1±59.5）min,术中出血量325（200,450）ml,手术切缘均达到R0切除标准。10例患者的术后总胆红素、直接胆红素、ALT、AST、CA199均比术前下降（P均< 0.05）。术后发生B级胰瘘1例,经保守治疗后痊愈,无围术期死亡病例。结论 数字化技术适用于胰头癌的术前规划和术中导航,有助于提高手术成功率,降低手术风险。

Application of digital technology in the surgery for pancreatic head carcinoma

Objective To evaluate the application value of digital technology in the surgery for pancreatic head carcinoma. Methods Clinical data of 10 patients with pancreatic head carcinoma were collected. Three-dimesnional （3D） visualization technology was employed to observe the variation of blood vessels, the invasion area of pancreatic head carcinoma, the relationship between tumor and blood vessels and the enlarged lymph nodes around the pancreas, etc. Meanwhile, 3D printing was used to conduct real-time surgical guidance. Preoperative planning results, surgical condition, changes of liver function and CA199 level after operation, postoperative complications and short-term efficacy were analyzed. Results All 10 patients successfully completed preoperative planning and intraoperative navigation based on digital technology. Surgical treatment was performed successfully in all patients. The average operation time was （315.1±59.5） min, and the mean intraoperative blood loss was 325 （200, 450） ml. All of them reached the criteria of R0 resection. The levels of total bilirubin （TBIL）, direct bilirubin （DBIL）, alanine aminotransferase （ALT）, aspartate aminotransferase （AST） and CA199 were significantly decreased after operation （all P < 0.05）. Postoperatively, 1 patient developed grade B pancreatic fistula and was recovered through conservative treatment. No perioperative death was reported. Conclusion Digital technology is applicable to preoperative planning and intraoperative navigation of pancreatic head carcinoma, which contributes to improving the success rate of surgery and lowering the risk of surgery.