关键词: 复杂性肝胆管结石, CT检查, 三维可视化重建, 结石清除

Abstract: Objective The purpose of this study was to explore the application of pre-operational three-dimensional visualization technology (3DVT) by CT scan in guiding operation in patients with complex hepatolithiasis. Methods 174 patients with complicated hepatolithiasis were admitted to our hospital between January 2016 and January 2018, and all patients underwent upper abdominal spiral CT plain scan with dynamic enhanced scan before surgery. After obtaining high-quality thin-slice CT data, the 3d visualization reconstruction was completed under the medical image three-dimensional visualization system. The surgical planning was formulated. Results The three-dimensional reconstruction was eventually completed in all the patients, and the simulated surgical scheme was completely consistent with the actual surgical operation; 81 out of 174 patients underwent exploration of common bile duct incision, and 93 patients underwent partial hepatectomy due to the presence of multiple stones and/or atrophicliver lobes or segments; the volume of pre-resected liver was (241.8± 26.5) mm³, and the actual volume of resected liver was (239.4 ± 24.8) mm³(P>0.05);during a follow-up of 24 to 32 months, 174 patients survived, and the CT scan found relapse of stones in 11patients(6.3%).Conclusion The application of 3DVT technology in the preoperative evaluation of complex hepatolithiasis is helpful to make up surgical plans, and guide the operation, which might precisely resect the hepatic lobe and improvethe clearance of stones in patients with complicated hepatolithiasis.

Key words: Complex hepatolithiasis, CT scan, Three-dimensional visualization technology, Stone clearance