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[三维成像技术在复杂肝胆外科手术中的应用进展]

[Progress in application of three-dimensional imaging technique in complex hepatobiliary surgery].

作者信息

Ji G W, Zhu F P, Li X C

机构信息

Liver Transplantation Center, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2017 Apr 1;55(4):316-320. doi: 10.3760/cma.j.issn.0529-5815.2017.04.016.

Abstract

Hepatobiliary surgery is considered to be technically challenging because of complex intrahepatic and perihilar anatomical structures and variations.Nowadays, three-dimensional imaging technique plays an important role in the time of precise liver surgery.Three-dimensional images depict the spatial location of tumor, and the course, confluence pattern and variation of portal vein, hepatic artery, biliary system and hepatic vein distinctly while showing involved hepatic segments and the relationship with adjacent vessels from omnidirectional view, measuring the length of margin and future remnant liver.With the help of surgical simulation, surgeons can determine the significant vessels preoperatively.The application of three-dimensional imaging technique may improve the resectability and safety of complex hepatobiliary surgery, such as hilar cholangiocarcinoma, centrally located liver tumor, hepatolithiasis and living donor liver transplantation.Meanwhile, three-dimensional visualization facilitates the understanding of two-dimensional images and complicated surgical anatomy for surgeons.

摘要

由于肝内和肝门周围解剖结构复杂且存在变异,肝胆外科手术在技术上具有挑战性。如今,三维成像技术在精准肝脏手术时代发挥着重要作用。三维图像能清晰描绘肿瘤的空间位置、门静脉、肝动脉、胆道系统和肝静脉的走行、汇合模式及变异情况,同时从全方位视角显示受累肝段以及与相邻血管的关系,测量切缘长度和未来残余肝脏。借助手术模拟,外科医生可在术前确定重要血管。三维成像技术的应用可能会提高复杂肝胆手术(如肝门胆管癌、肝中央型肿瘤、肝内胆管结石和活体肝移植)的可切除性和安全性。同时,三维可视化有助于外科医生理解二维图像和复杂的手术解剖结构。

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