Application Of Three-dimensional Visualization Combined With Virtual Reality Technology And ICG Molecular Fluorescence Technology In Hilar Cholangiocarcinoma

PurposeTo explore the feasibility of Three-dimensional visualization combined with virtual reality and ICG molecular fluorescence imaging in surgical treatment of hilar cholangiocarcinoma,and to evaluate its practical value in preoperative evaluation,intraoperative navigation and bile leakage detection of hilar cholangiocarcinoma.MethodData were collected from 71 patients with hilar cholangiocarcinoma who underwent surgical treatment in our hospital from January 2009 to October 2018.Among them,41 patients in group A underwent preoperative evaluation and surgical plan in 3D visualization model and virtual reality technology guidance.and according to the situation by using 3D printing technology and ICG molecule fluorescence imaging technology assisted surgical treatment of hilar cholangiocarcinoma;30 patients in group B were treated with traditional imaging evaluation.Analyze the consistency of traditional imaging assessment and 3D visualization combined with virtual reality technology assessment and patient actual situation,compare and analyze the perioperative indicators of two groups of patients,evaluate 3D visualization combined with virtual reality technology,ICG molecular fluorescence technology in the surgical treatment of hilar cholangiocarcinoma.ResultAll the 41 patients in group A obtained 3d visualization models and virtual reality models with clear structure and three-dimensional continuity,and the surgical planning was performed after the patient's individualized three-dimensional visualization.Among them,9 patients underwent navigation surgery assisted by 3D printing technology,and 8 patients completed the range boundary and bile leakage detection of anatomical hepatic segment/lobe assisted by ICG molecular fluorescence imaging technology.The postoperative complication rate of group A was 6/41(14.6%),including 2 cases of pleural effusion,3 cases of pulmonary infection,and 1 case of bile leakage.All were classified as grade I of Clavien-Dindo complications.After symptomatic treatment After recovery,41 patients had no perioperative death.All the 30 patients in group B underwent surgical treatment after traditional imaging evaluation.The postoperative complication rate was 12/30(40.0%),including 1 case of wound infection,5 cases of pleural effusion,4 cases of pulmonary infection,and abdominal cavity.1 case of hemorrhage,1 case of bile leakage,11 cases of grade 1 of Clavien-Dindo complications,3 cases of grade ?,30 patients had no perioperative death.In group A,the diagnostic accuracy of Bismuth typing of hilar bile duct carcinoma under the guidance of 3DVS/VR was 41/41(100%),while the diagnostic accuracy under the guidance of CT/MRI was only 34/41(82.93%),P<0,05,indicating A statistically significant difference.Postoperative indicators of patients in group A,such as length of stay and complication rate,were lower than those in group B,P<0.05,indicating A statistically significant difference.Conclusion3D visualization technology combined with virtual reality technology and ICG molecular fluorescence imaging technology provides a new diagnosis and treatment mode for surgical treatment of hilar cholangiocarcinoma,which can more accurately assess the patient's anatomy,make individual operation planning,reduce complications,shorten hospitalization time,has certain clinical application value and prospect.