Application Of Three-dimensional Visualization In Radical Resection Of Hilar Cholangiocarcinoma

Objective To explore the value of three-dimensional visualization in radical resection of hilar cholangiocarcinoma.Methods Forty-one patients with hilar cholangiocarcinoma diagnosed by pathology in the General Hospital of Ning Xia Medical University from July 2018 to January 2021 were analyzed retrospectively.the patients who used 3D visualization technique for model reconstruction before operation were set as 3D group(experimental group),and those without3 D visualization model reconstruction before operation were taken as control group.Among the 41 patients,there were 14 females(34.1%)and 27 males(65.9%),aged 44-72 years,with an average age of 61.29 ±7.15 years.There were 14 cases of Bismuth-Corlette type II,23 cases of type III(11 cases of type IIIA,12 cases of type IIIb)and 4 cases of type IV.The 3D group used 3D visualization technology to make preoperative diagnosis and record the consistency with the real situation during the operation,and compared with the control group to evaluate the superiority of 3D visualization technology in the preoperative evaluation of HCCA.Results In 3D group,the accuracy,specificity and sensitivity of portal vein invasion were 90.0%,93.3% and 80.0%,respectively,and the accuracy,specificity and sensitivity of hepatic artery invasion were 85.0%,92.9% and 66.7%,respectively.The accuracy of preoperative 3DV classification was 90.0%.Compared with the control group,the intraoperative blood loss,operation time and postoperative hospital stay in the 3D group were(392.50 ±126.98)ml,(528.61 ±252.27)ml;(4.91 ±0.92,5.74 ±1.55)h;(14.30 ±2.96d)and(16.52 ±3.74d)d,respectively,which were superior to the control group in reducing intraoperative blood loss,operation time and postoperative hospital stay.There was a high correlation between the preoperative simulated resected volume and the intraoperative resected liver volume in 20 cases in 3D group(P< 0.01).Conclusion Three-dimensional visualization technology is more accurate in identifying HCCA classification,which can help clinicians to make accurate evaluation before operation,help clinicians to make rapid decisions on difficult anatomy during operation,and significantly shorten operation time,reduce operative bleeding,reduce the occurrence of postoperative complications and shorten the days of hospitalization.Three-dimensional visualization technology plays an important role in the radical treatment of HCCA and is expected to provide individual and accurate treatment for patients.