[Application of digitalized minimally invasive technique in treatment of hepatolithiasis based on MI-3DVS].
OBJECTIVE
To assess the clinical value of digitalized minimally invasive technique in the treatment of the hepatolithiasis.


METHODS
The 64-slice spiral CT data were acquired from 4 hepatolithiasis patients for three-dimensional reconstruction and simulation operation using abdominal medical image-3D visualization system (MI-3DVS). Three-dimensional reconstruction was performed for the liver, hepatic arteries, hepatic veins, portal veins, intrahepatic bile ducts and calculi. Based on the size and position of the calculi and the distribution of the dilated or stenotic biliary ducts, several simulation operations such as partial hepatectomy and hepaticojejunstomy were performed. With guidance by the findings in the simulation operation, the actual minimally invasive operation was performed.


RESULTS
The three-dimensional models of the liver, hepatic arteries, hepatic veins, portal veins, intrahepatic bile ducts and calculi were reconstructed successfully, which clearly visualized the site and the number of calculi and the condition of the involved intrahepatic bile ducts. Guided by the three-dimensional models and the simulation operations, partial hepatectomy and hepaticojejunstomy were performed and the calculi were removed completely in all the 4 cases with maximum preservation of the residual liver volume.


CONCLUSIONS
Three-dimensional reconstruction and simulation operation allows digital minimally invasive treatment of hepatolithiasis, which can be a new approach to hepatobiliary surgery.
First Department of Hepatobiliary Surgery, Southern Medical University, Guangzhou, China. fanyf068700@sina.com
Ying-fang
YF
Fan
Nan
N
Xiang
Chi-hua
CH
Fang
D000328:Adult; D000368:Aged; D017734:Bile Ducts, Extrahepatic / Q000000981:diagnostic imaging / Q000601:surgery; D001653:Bile Ducts, Intrahepatic / Q000000981:diagnostic imaging / Q000601:surgery; D003198:Computer Simulation; D005260:Female; D042882:Gallstones / Q000000981:diagnostic imaging / Q000601:surgery*; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D036542:Tomography, Spiral Computed