Application Of Three-dimensional Visualization Combined With Laparoscopic Ultrasound In Laparoscopic Resection Of Liver Malignant Tumor

Objective: To evaluate the value of three-dimensional visualization combined with laparoscopic ultrasound navigation in perioperative period of laparoscopic hepatectomy in patients with liver malignant tumor.Methods: The clinical data of 75 patients with liver malignant tumor who underwent laparoscopic hepatectomy in the Department of Hepatobiliary and Pancreatic surgery of Fuyang people’s Hospital from March 2019 to January2022 were analyzed retrospectively.among them,37 cases of liver malignant tumor were treated with three-dimensional visualization combined with laparoscopic ultrasound(observation group)and 38 cases of routine laparoscopic hepatectomy(control group).Collect the general baseline data of the two groups,biochemical indexes before and after operation(glutamic pyruvic transaminase,aspartate aminotransferase,total bilirubin,albumin,prothrombin time,hemoglobin,etc.),intraoperative data(operation time,blood loss,intraoperative blood transfusion,conversion to laparotomy and causes),postoperative data(postoperative hospital stay,removal time of postoperative abdominal drainage tube,postoperative complications,postoperative pathology,Positive rate of cutting edge.The liver function,the incidence of postoperative complications and short-term postoperative recurrence were compared between the two groups.Results: There was no significant difference in preoperative baseline data and liver function indexes between the two groups.Compared with the control group,the observation group had lower intraoperative blood loss(170.00±78.17 ml vs326.84 ml ± 306.90 ml,P<0.05),shorter removal time of abdominal drainage tube(6.36 d±1.96 d vs 7.97±2.88 d,P<0.05)and postoperative hospital stay(8.82 d ± 2.34d),lower incidence of postoperative complications and positive rate of postoperative pathological margin(P<0.05).The liver function index of the observation group was better than that of the control group on the 1st and3 rd day after operation(P<0.05),but there was no significant difference in operation time,ICU occupancy rate,conversion to laparotomy rate and short-term tumor recurrence rate between the two groups(P>0.05).There was no death during hospitalization in both groups.Conclusion: Three-dimensional visualization combined with laparoscopic ultrasound is safe and feasible for laparoscopic hepatectomy for liver malignant tumors.It can also reduce operative blood loss,reduce postoperative complications and reduce the positive rate of surgical margin,which is worth popularizing in prefectural and municipal hospitals.