肝脏CT三维重建评估肝门部胆管癌根治术临床应用研究  

Evaluation by CT three dimensional reconstruction in patients with hilar cholangiocarcinoma underwent hepatectomy

作　　者：李连海[1] 许惠玲[1] 王金榜[2] Li Lianhai;Xu Huiling;Wang Jinbang(Department of General Surgery,First People’s Hospital,Nanyang 473012,Henan Province)

机构地区：[1]河南省南阳市第一人民医院普外一科,473012 [2]河南省肿瘤医院普外科

出　　处：《实用肝脏病杂志》2018年第6期947-950,共4页Journal of Practical Hepatology

基　　金：河南省重点科技攻关项目(编号:152102310428)

摘　　要：目的探讨CT三维重建评估在肝门部胆管癌根治术中的临床应用价值。方法回顾性分析2013年1月～2017年1月收治的33例肝门部胆管癌(HCCA)患者的临床资料,19例术前采用CT三维重建评估,14例术前经CT检查评估。将CT检查数据导入3D-liver三维重建软件,建立肝脏三维模型。结果 19例三维重建组患者行R0切除12例(63.2%),14例对照组R0切除6例(42.9%,P<0.05);术中出血量分别为(425.3±124.5)ml和(539.4±234.7)ml(P<0.05);手术时间分别为(3.2±1.3) h和(4.1±2.5) h(P<0.05);术后住院时间分别为(11.7±4.8)d和(13.9±5.4)d (P<0.05);术后并发症发生率分别为10%和12%(P>0.05)。结论 CT三维重建评估HCCA肿瘤侵犯、肝血管变异和受累情况,制定恰当的肝切除手术预案,能提高肿瘤R0切除率,减少术中出血量和手术时间。Objective To investigate the application of CT three dimensional reconstruction in patients with hilar cholangiocarcinoma(HCCA)underwent hepatectomy.Methods 33 patients with HCCA were recruited in our hospital between January 2013 and January 2017,and CT three dimensional reconstruction was performed in 19 patients and conventional CT check-up was done in 14 before operation.Results The tumor R0 resection in patients receiving CT three dimensional reconstruction before operation was completed in 12 patients with HCCA(63.2%),while it was done in 6(42.9%)in the control group(P<0.05);the intraoperative blood loss were(425.3±124.5)ml and(539.4±234.7)ml(P<0.05);the operation time were(3.2±1.3)h and(4.1±2.5)h(P<0.05);the postoperative hospital stay were(11.7±4.8)d and(13.9±5.4)d(<0.05),and the postoperative complications were 10%and 12%(P>0.05),respectively,in the two groups.Conclusion CT three-dimensional reconstruction before operation might be helpful in evaluation of tumor invasion and hepatic blood vessels involvement,and in rehearsing the hepatectomy.

关 键 词：肝门部胆管癌 CT三维重建 肝切除术 疗效 

分 类 号：R735.8[医药卫生—肿瘤]