三维可视化技术在肝门部胆管癌术前评估中的应用

  目的  探讨三维可视化技术在肝门部胆管癌术前评估中的应用价值。  方法  收集2014年3月至2016年4月蚌埠医学院第一附属医院38例肝门部胆管癌手术患者临床资料，将所有患者分为两组，对照组术前未行三维可视化重建（n=20），观察组术前行三维可视化重建（n=18）。分析两组术前诊断结果与术中实际情况的相符程度，并比较两组相关手术指标。  结果  在肿瘤纵向和门静脉、肝动脉垂直方向侵犯评估中，观察组和对照组都具有较高的准确率，二者无显著性差异。而在肝门部解剖分型上，观察组中所有患者分型与术中实际吻合，吻合率高于对照组（100% vs. 70%，P＜0.05），同时对肝体积的预估和实测更加精确（r=0.986，P＜0.001）。此外，与对照组相比，观察组平均术中出血量、手术时间明显减少（P＜0.05），R0切除率无明显差异。  结论  三维可视化技术能精准完成肝门部胆管癌术前评估。 

Application of three-dimensional visualization technology in preoperative assessment of hilar cholangiocarcinoma

Objective:To investigate the application of three-dimensional visualization technology in preoperative assessment of hilar cholangiocarcinoma. Methods:Thirty-eight patients with hilar cholangiocarcinoma who underwent surgery from March 2014 to April 2016 were enrolled in the retrospective study. Among the cases, an observational group of 18 patients had preoperative three-dimensional visualization surgical planning, while a control group of 20 patients did not have the visualization surgical plan. The preoperative diagnostic results were analyzed with the actual intraoperative findings. Related surgicall indicators between the two groups were compared. Results:No significant difference in the accuracy rates of longitudinal and vertical infiltration of cholangiocarcinoma between was observed the observational group and control group. While the vascular and ductal branching pattern of all patients are consistent with intraoperative findings, the coincidence rate was higher in the observational group than that in the control group (100%vs. 70%, P<0.05). The estimated liver volumes were also exactly consistent with the actual liver volume (r=0.986, P<0.001). In comparison with the control group, the average intraoperative blood loss and operative time of the observational group were significantly lower. However, the potential curative resection between the two groups exhibited no significant difference. Conclusion:Three-dimensional visualization technology can accurately complete the preoperative evaluation of hilarcholangiocarcinoma.