Yamanaka Junichi, Saito Shinichi, Iimuro Yuji, Hirano Tadamichi, Okada Toshihiro, Kuroda Nobukazu, Sugimoto Takaaki, Fujimoto Jiro
First Department of Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan.
J Hepatobiliary Pancreat Surg. 2006;13(5):363-9. doi: 10.1007/s00534-005-1075-z.
BACKGROUND/PURPOSE: In living-donor liver transplantation, accurate assessments of liver graft volume and anatomical variation are mandatory for the preoperative planning of safe donor hepatectomy and successful recipient implantation. The aim of this study was to assess the feasibility and accuracy of novel three-dimensional (3-D) virtual hepatectomy simulation software in living-donor liver transplantation.
We developed the hepatectomy simulation software, which was programmed to analyze detailed 3-D vascular structure and to predict liver graft volume, based on hepatic circulation.
In 101 individuals, including 4 living donors, the predicted liver resection volumes revealed a significant correlation with the actual value (P < 0.0001), with a mean difference of 7.9 ml. The drainage area by the individual hepatic vein branch was quantified to achieve reconstruction of the corresponding venous branch. The application of multidetector computed technology scanning and virtual cholangioscopy facilitated more detailed visualization of the 3-D hilar anatomy in a left trisectoral graft transplantation.
This hepatectomy simulation software reliably predicted accurate liver graft volume and the drainage volume of hepatic vein branches. This software may contribute to the preoperative planning of safe donor hepatectomy and implantation with satisfactory graft viability.
背景/目的：在活体肝移植中，准确评估肝移植体积和解剖变异对于安全供肝切除术的术前规划和成功的受体植入至关重要。本研究的目的是评估新型三维（3-D）虚拟肝切除术模拟软件在活体肝移植中的可行性和准确性。
我们开发了肝切除术模拟软件，该软件基于肝循环进行编程，以分析详细的三维血管结构并预测肝移植体积。
在包括4名活体供体在内的101名个体中，预测的肝切除体积与实际值显示出显著相关性（P < 0.0001），平均差异为7.9毫升。通过量化个体肝静脉分支的引流区域来实现相应静脉分支的重建。多探测器计算机技术扫描和虚拟胆管镜检查的应用有助于在左三叶移植中更详细地显示三维肝门解剖结构。
这种肝切除术模拟软件可靠地预测了准确的肝移植体积和肝静脉分支的引流体积。该软件可能有助于安全供肝切除术的术前规划和具有满意移植活力的植入。
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