IQQA-3D精准评估在肝门胆管癌经皮穿肝胆管引流术及经皮胆道支架植入术治疗中的应用  

Application of three-dimensional visualization technique accurate assessment in performing percutaneous transhepatic biliary drainage and percutaneous transhepatic biliary stenting for hilar cholangiocarcinoma

作　　者：李海 葛乃建 何成建 王向东 黄剑 徐伟 杨业发 LI Hai;GE Naijian;HE Chengjian;WANG Xiangdong;HUANG Jian;XU Wei;YANG Yefa(Mini-inasine Internention Center,Third Afliated Hospial of Naval Miliary Medical University,Shanghai 200438,China)

机构地区：[1]海军军医大学第三附属医院微创介入中心,上海200438

出　　处：《介入放射学杂志》2022年第9期875-878,共4页Journal of Interventional Radiology

基　　金：国家自然科学基金(31971249)。

摘　　要：目的 初步探讨基于IQQA-3D Liver系统的三维可视化技术在肝门部胆管癌(HCCA)患者行经皮穿肝胆管引流术(PTBD)或经皮胆道内支架植入术(PTBS)减黄中的应用价值。方法 回顾性分析2019年8月至2021年10月收治的6例HCCA患者的临床资料,结合术前三维数据,初步探讨该技术对HCCA患者行PTBD或PTBS治疗的指导价值。结果 6例患者术前三维模型结构清晰,可立体显示肝血管系统、肝内外肿瘤病灶、胆道系统三者的空间关系,可测量肝内胆管1级分支直径、胆管狭窄段长度。结合术中超声及DSA图像,6例患者均成功实施PTBD或PTBS治疗,未出现手术相关并发症,术后总胆红素下降明显。6例HCCA患者中3例行PTBD,最后均成功行肝门胆管癌根治术。结论 IQQA-3D精准评估有助于制定肝门胆管癌患者行PTBD或PTBS手术策略,可以提高手术的安全性和精准性。Objective To discuss the application of three-dimensional visualization technique based on IQQA-3D liver system in performing percutaneous transhepatic biliary drainage(PTBD) and percutaneous transhepatic biliary stenting(PTBS) for reducing jaundice in patients with hilar cholangiocarcinoma(HCCA).Methods The clinical data of 6 patients with HCCA, who were admitted to the Affiliated Eastern Hepatobiliary Surgery Hospital of China between August 2019 and October 2021 to receive treatment, were retrospectively analyzed. Combining the preoperative 3D data, the guiding value of three-dimensional visualization technique based on IQQA-3D liver system in performing PTBD or PTBS was assessed. Results In 6 patients, the preoperative three-dimensional model demonstrated a clear anatomical structure, which stereoscopically displayed the spatial relationships between the hepatic vasculature, the intrahepatic tumor lesions,extrahepatic tumor lesions, and the biliary system. The diameter of the first-level branch of intrahepatic biliary duct, the length of the biliary duct stenosis could be accurately measured. With the help of intraoperative ultrasound and DSA images, PTBD or PTBS was successfully accomplished in all the 6 patients. No procedure-related complications occurred. The postoperative total bilirubin level was significantly decreased.Among 6 HCCA patients, 3 patients received PTBD which was followed by successful radical resection of HCCA. Conclusion In treating HCCA patients, IQQA-3D accurate assessment is helpful for formulating PTBD or PTBS surgical strategies, which can remarkably improve the safety and accuracy of the surgery.(J Intervent Radiol, 2022, 31: 875-878)

关 键 词：三维可视化 肝门部胆管癌 经皮穿肝胆管引流术 经皮胆道内支架植入术 

分 类 号：R735.8[医药卫生—肿瘤]