三维重建技术联合3D腹腔镜在肝脏手术中的应用  

Application of 3D reconstruction combined with 3D laparoscopy in liver surgery

作　　者：倪忠鹏 张昕辉[1] 王晓川[1] 张烜烽 郑文龙 杨怀亮 NI Zhongpeng;ZHANG Xinhui;WANG Xiaochuan(Hepatobiliary and Pancreatic Center,Xuzhou Central Hospital,Jiangsu,Xuzhou 221000,China)

机构地区：[1]江苏省徐州市中心医院肝胆胰中心,221000

出　　处：《临床外科杂志》2022年第12期1133-1136,共4页Journal of Clinical Surgery

摘　　要：目的探讨三维重建技术联合3D腹腔镜在肝脏手术中的应用价值。方法选取2020年6月~2021年12月我院肝胆胰中心符合条件的病人37例,所有病人均于术前完善三维重建以明确肝脏的血管走行情况及与病变的毗邻关系,术中使用3D腹腔镜技术进行操作,观察手术方式、手术时间、术中出血量、术后住院时间、术后并发症情况等。结果37例病人均于腔镜下完成手术,无中转开腹,手术时间60~420分钟,平均(226±101)分钟;术中出血量50~1000 ml,平均(228±195)ml;术后肛门排气时间1~3天,平均(2.2±0.6)天;引流管拔除时间3~20天,平均(7.5±3.1)天;37例病人中,8例转氨酶及胆红素在术后第3天恢复正常值,术后第7天时所有未出院的病人转氨酶均位于100 U/L以内,胆红素均位于34μmol/L内;术后住院时间4~23天,平均(9.78±4.1)天;术后1例胆漏,8例胸腔积液,经保守治疗后治愈出院。结论三维重建技术联合3D腹腔镜在肝脏手术中安全可行,对控制术中出血、缩短手术时间、降低并发症有一定的价值。Objective To explore the application of 3D reconstruction combined with 3D laparoscopy in liver surgery.Methods The clinical data of 37 patients who met the corresponding conditions in the Hepatobiliary and Pancreatic Center of Xuzhou Central Hospital from June 2020 to December 2021 were retrospectively analyzed.All patients completed the 3D reconstruction before operation to clarify the blood vessel movement of the liver and its relationship with pathological changes,and the operation was performed by 3D laparoscopy,and the operation mode,operation time,intraoperative blood loss,hospital stay after operation and postoperative complications were observed.Results All 37 patients underwent laparoscopic surgery without conversion to open surgery.The operation time was 60-420 min,with an average of(226±101)min.Intraoperative blood loss ranged from 50 to 1000 ml,with an average of(228±195)ml.Postoperative anal exsufflation time was 1~3 days,with an average of(2.2±0.6)days.The removal time of the drainage tube was 3~20 days,with an average of(7.5±3.1)days.Among the 37 patients,the levels of transaminase and bilirubin in 8 patients returned to normal on the 3rd day after surgery.On the 7th day after surgery,transaminase and bilirubin were all within 100 U/L and 34μmol/L in all patients who were not discharged.Postoperative hospital stay was 4-23 d,with an average of(9.78±4.1)d.A total of 1 case of biliary leakage and 8 cases of pleural effusion occurred after operation,and they were cured and discharged after conservative treatment.Conclusion 3D reconstruction combined with 3D laparoscopy is safe and reliable in liver surgery,and has certain effects on controlling intraoperative bleeding,shortening operation time and reducing complications.

关 键 词：腹腔镜肝切除 三维重建 3D腹腔镜 

分 类 号：R657.3[医药卫生—外科学]