关键词: 复杂性肝胆管结石, CT三维可视化技术, 肝段切除, 治疗

Abstract: Objective The aim of this study was to observe the efficacy of laparoscopic precision liver segment resection under CT three-dimensional visualization technology guidance in the treatment of patients with complex hepatolithiasis. Methods 63 patients with complex hepatolithiasis were encountered in our hospital between January 2016 and December 2022, were divided into observation and control groups, and all patients underwent segmental hepatectomy and fiberoptic cholangioscopy. In the observation group, the CT three-dimensional visualization technology was applied to personally reveal, design operation plan and mimic the operation pre-operationally. All patients were followed-up for one year. Results The surgical time, intraoperative blood loss and hospital stay after operation in the observation group were 101.8(96.4,117.6)min, (25.9±6.7)mL and (9.6±1.5)d, all significantly shorter or less than [121.3(98.5,135.4)min, (37.7±15.9)mL and (11.9±2.7)d, respectively, P<0.05] in the control, while there was no significant difference as respect to recovery of intestinal functions in the two groups [(2.6±0.3)d vs. (2.8±0.6)d, P＞0.05]; post-operationally, total serum bilirubin, albumin and ALP levels in the observation group were (15.6±8.4)μmol/L, (35.6±2.3)g/L and (78.1±21.2)U/L, all not significantly different compared to [(17.1±1.4)μmol/L, (36.8±2.7)g/L and (99.2±21.3)U/L, P＞0.05] in the control; the incidence of complications, such as incision infection, biliary bleeding, biliary injury and biliary leakage in the observation was 16.1%, much lower than 53.1%(P<0.05) in the control; two weeks after surgery, the imaging showed that the stone clearance rate in the observation group was 96.8%, much higher than 75.0%(P<0.05) in the control, and at the end of one-year follow-up, the imaging demonstrated that the stone recurrence rate in the observation group was 3.2%, much lower than 18.8%(P<0.05) in the control group. Conclusion The laparoscopic precision liver segment resection under CT three-dimensional visualization technology guidance in the treatment of patients with complex hepatolithiasis is efficacious, which could improve stone clearance rate, with less complications and low stone recurrence, and warrants further clinical exploration.

Key words: Complex hepatolithiasis, CT 3D visualization, Liver segment resection, Therapy