摘要
目的探讨三维可视化技术在胆囊癌根治术中的应用价值.方法回顾性分析2014年1月至2016年12月东方肝胆外科医院收治的56例胆囊癌患者的临床资料,应用三维可视化影像系统将患者术前二维CT图像进行三维可视化重建,通过观察肿瘤与临近肝脏、血管、胆管、淋巴管之间的关系,评估根治的可能性,模拟手术规划,预估手术风险.通过对患者实施根治性手术,比较重建结果与实际手术的区别,统计分析手术时间、术中出血量、术中输血量、并发症发生情况.结果56例患者三维可视化重建后图像清晰立体地显示胆囊肿瘤及侵犯的肝组织,转移的淋巴结以及与第一肝门的解剖结构及毗邻关系,均顺利完成胆囊癌根治术,三维重建肿瘤的解剖关系与术中情况大致相符.结论采用三维可视化技术能够对胆囊癌患者术前进行精准手术规划评估,提高手术根治率,降低围手术期风险,具有一定的临床应用价值.
Objective To explore the application value of three-dimensional visualization technology in radical operation of gallbladder cancer. Methods The clinical and follow-up data of fifty-six patients of gallbladder cancer were retrospectively, who were treated from January 2014 to December 2016 in the Department of Hepatobiliary Surgery, Eastern Hepatobiliary Hospital, Second Military Medical University. The three-dimensional visualization of the patient’s preoperative two-dimensional CT image was reconstructed using a three-dimensional visualization system. By observing the relationship between the tumor and the adjacent liver, blood vessels, bile ducts, and lymphatic vessels, the possibility of radical cure was evaluated, surgical planning was simulated, and the surgical risk was estimated. By performing radical surgery on patients, the difference between reconstruction results and actual surgery was compared, and the operation time, intraoperative blood loss, intraoperative blood transfusion, and complications were statistically analyzed. Results After three-dimensional visual reconstruction, the images of 56 patients showed the gallbladder tumor, the involved liver tissue, the metastatic lymph nodes, the anatomical structure and the adjacent relationship with the first porta hepatic. All patients successfully completed the radical operation of gallbladder cancer. The anatomic relationship of the three-dimensional reconstruction tumor was similar to that of the operation. Conclusions The application of three-dimensional visualization technology can accurately evaluate the preoperative operation planning of patients with gallbladder cancer, improve the radical operation rate and reduce the perioperative risk, which has certain clinical application value.
作者
温志坚
闫兴洲
陈战
杨平华
张宝华
WEN Zh-ijian;YANXing-hou;CHEN Zhan(Deparment of Ceneral Surgery,Armly 73rd group military hospital of PLA,Key Laboratory of BiliaryTract,Xiamen 361003,China)
出处
《肝胆外科杂志》
2020年第6期453-457,472,共6页
Journal of Hepatobiliary Surgery
关键词
胆囊癌
三维可视化
根治术
gallbladder cancer
three-dimensional visualization
radical surgery
作者简介
通讯作者:张宝华。
