Li Xiaofeng, Duan Renpeng, He Yifeng, Qin Jiawei, Liu Ruijian, Dai Siqin, Zhou Jiawei, Zeng Xiancheng, Duan Juan, Gao Peng, Yang Xiaoqiao, Li Cheng
Guangdong Provincial Emergency Hospital, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, China.
The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China.
Front Surg. 2022 Aug 2;9:934183. doi: 10.3389/fsurg.2022.934183. eCollection 2022.
This study aimed to establish three-dimensional models of the biliary tract of Chinese people using the Hisense computer-aided surgery (CAS) system and to explore the branching patterns and variation types of the biliary system under the study of 3D reconstruction of the biliary tract. Three-dimensional models of the biliary tract were reconstructed in 50 patients using the Hisense CAS system. The branching patterns of intrahepatic bile ducts were observed. The biliary tract was classified according to the confluence of the right posterior sectoral duct (RPSD), right anterior sectoral duct (RASD) and left hepatic duct (LHD), and the presence or absence of accessory hepatic ducts. The 3D models of the bile ducts were successfully reconstructed in 50 Chinese patients. The branching patterns of the bile ducts were classified into seven types. The anatomy of the bile ducts was typical in 54% of cases ( = 27), showed triple confluence in 10% ( = 5), and crossover anomaly in 14% ( = 7), which means anomalous drainage of the RPSD into the LHD, anomalous drainage of the RPSD into the common hepatic duct (CHD) in 10% ( = 5), anomalous drainage of the RPSD into the cystic duct (CD) in 2% ( = 1), absence of left main hepatic duct in 1% ( = 1), presence of accessory duct in 8% ( = 4). Among them, there were three cases of accessory hepatic ducts coexisting with other variation types. By using the Hisense CAS system to establish 3D models of the biliary tract of the Chinese people, we established the branching model of the second-order bile ducts, which has important value for the classification of the biliary system and its variation types.
本研究旨在利用海信计算机辅助手术(CAS)系统建立中国人胆道的三维模型,并在胆道三维重建研究下探索胆道系统的分支模式和变异类型。使用海信CAS系统对50例患者的胆道进行三维模型重建。观察肝内胆管的分支模式。根据右后叶胆管(RPSD)、右前叶胆管(RASD)和左肝管(LHD)的汇合情况以及副肝管的有无对胆道进行分类。成功对50例中国患者的胆管进行了三维模型重建。胆管分支模式分为七种类型。54%(n = 27)的病例胆管解剖典型,10%(n = 5)表现为三联汇合,14%(n = 7)表现为交叉异常,即RPSD异常引流至LHD,10%(n = 5)的RPSD异常引流至肝总管(CHD),2%(n = 1)的RPSD异常引流至胆囊管(CD),1%(n = 1)无左肝总管,8%(n = 4)有副肝管。其中,有3例副肝管与其他变异类型并存。通过利用海信CAS系统建立中国人胆道的三维模型,我们建立了二级胆管的分支模型,这对胆道系统及其变异类型的分类具有重要价值。