Does preoperative analysis of intrahepatic venous anastomoses improve the surgeon's intraoperative decision making? Pilot data from a case report.
BACKGROUND
Three-dimensional (3D) visualization is thought to improve the anatomical understanding of clinicians, thus improving patient safety.


METHODS
A 58-year-old male was admitted to our hospital in April 2007 with a suspected metastasis of a sigmoid cancer in the Couinaud segment (CS) 7. The anatomical situation of this patient was analyzed using both a CT scan and 3D images. The initial CT scan revealed that the proximal part of the middle hepatic vein was completely missing and the metastasis in the CS 7 was closely attached to the right hepatic vein. After analyzing additional 3D images, it became clear that due to the close proximity of metastasis and right hepatic vein, the resection of the right hepatic vein was inevitable. Based on this 3D analysis, it was decided to perform a right-sided hemihepatectomy. In this case report, 3D visualization resulted in a faster and clearer understanding of the unique anatomical situation in a patient with complicated liver anatomy than transversal CT images.


CONCLUSIONS
The here presented data shows for the first time 3D visualization of intravenous anastomoses in the human liver. The information offered by 3D visualization is not redundant but rather serves as a true source of additional information, indicating the potential benefit of 3D visualization in surgical operation planning.
Fischer
Lars
L
Department of Surgery, University of Heidelberg, INF 110, D-69120 Heidelberg, Germany. Bruno.Schmied@med.uni-heidelberg.de.
Schoebinger
Max
M
Neumann
Jan-Oliver
JO
Müller
Sascha
S
Meinzer
Hans-Peter
HP
Büchler
Markus W
MW
Schmied
Bruno M
BM