title: A novel 3D hepatectomy simulation based on liver circulation: application to liver resection and transplantation.
abstract: Hepatectomy is a complicated operative procedure because of its anatomical complexity, vascular variability, and impaired hepatic function due to associated hepatitis or cirrhosis. Thus preoperative detailed topography and precise liver resection volume measurements should be obtained for a curative hepatectomy. The aim of this study was to assess the feasibility and accuracy of a novel three-dimensional (3D) virtual hepatectomy simulation software in patients who underwent liver resection or living donor liver transplantation. We developed the hepatectomy simulation software, which was programmed to analyze detailed 3D vascular structure and to predict liver resection volume and margins. In 72 patients receiving hepatectomy, the predicted liver resection volumes and margins revealed a significant correlation with the actual value with a mean difference of 9.3 mL (P < .0001) and 1.6 mm (P < .01), respectively. The drainage area by hepatic veins was quantified to achieve reconstruction of the corresponding venous branch. In conclusion, this hepatectomy simulation software reliably predicted an accurate liver resection volume, the cancer-free margin, and the drainage volume of hepatic vein branches. This software may promote curative hepatectomy and may be used for other interventional therapies in the treatment of liver disease.
authors.affiliation: First Department of Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Saito
authors.forename: Junichi
authors.initials: J
authors.lastname: Yamanaka
authors.forename: Koui
authors.initials: K
authors.lastname: Miura
authors.forename: Norio
authors.initials: N
authors.lastname: Nakao
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Nagao
authors.forename: Takaaki
authors.initials: T
authors.lastname: Sugimoto
authors.forename: Tadamichi
authors.initials: T
authors.lastname: Hirano
authors.forename: Nobukazu
authors.initials: N
authors.lastname: Kuroda
authors.forename: Yuji
authors.initials: Y
authors.lastname: Iimuro
authors.forename: Jiro
authors.initials: J
authors.lastname: Fujimoto
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D003198:Computer Simulation / Q000592:standards; D005260:Female; D006498:Hepatectomy; D006801:Humans; D021621:Imaging, Three-Dimensional; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D008102:Liver Circulation; D008107:Liver Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D012984:Software; D014057:Tomography, X-Ray Computed; D014584:User-Computer Interface