title: Individualized preoperative planning using three-dimensional modeling for Bismuth and Corlette type III hilar cholangiocarcinoma.
abstract: BACKGROUND
  A detailed evaluation of blood supply anatomy, especially the biliary anatomy at the hepatic hilus, is essential to ensure a complete and curative resection for Bismuth and Corlette type III hilar cholangiocarcinoma. The study aimed to investigate the impact of individualized preoperative planning using 3D modeling on surgical treatment for type III hilar cholangiocarcinoma.
  
  
  METHODS
  This was a retrospective study of patients with type III hilar cholangiocarcinoma (n=47) who underwent surgery at the Hepatobiliary Surgery Department of Zhujiang Hospital between March 2007 and January 2015. All patients had undergone preoperative computed tomography (CT) examination, and 3D images were reconstructed. Preoperative surgery simulation was performed, and the simulation was applied in the subsequent surgery. Clinical, surgical, and pathological characteristics were compared between patients undergoing preoperative planning (n=25) and those who did not (n=22). Complications were examined.
  
  
  RESULTS
  Surgical time and blood loss were significantly smaller in patients with 3D reconstruction compared to those without. The number of bile duct orifices was correctly estimated in 14/25 (56.0%) patients with preoperative planning. The width of the hepatic surgical margin could be measured for 18 hepatic ducts, and 17 (68.0%) of them were pathologically diagnosed as margin-negative.
  
  
  CONCLUSIONS
  This technique has the advantages of precise visualization of the anatomic structures and 3D assessment of biliary branches and vessels, allowing improved operative planning for the treatment of hilar cholangiocarcinoma.
authors.affiliation: Department of Hepatobiliary Surgery, Zhujiang Hospital of Southern Medical University, Guangzhou, 510282, China.
authors.forename: Ning
authors.initials: N
authors.lastname: Zeng
authors.affiliation: Department of Hepatobiliary Surgery, Zhujiang Hospital of Southern Medical University, Guangzhou, 510282, China.
authors.forename: Haisu
authors.initials: H
authors.lastname: Tao
authors.affiliation: Department of Hepatobiliary Surgery, Zhujiang Hospital of Southern Medical University, Guangzhou, 510282, China. fangchihua15@163.com.
authors.forename: Chihua
authors.initials: C
authors.lastname: Fang
authors.affiliation: Department of Hepatobiliary Surgery, Zhujiang Hospital of Southern Medical University, Guangzhou, 510282, China.
authors.forename: Yingfang
authors.initials: Y
authors.lastname: Fan
authors.affiliation: Department of Hepatobiliary Surgery, Zhujiang Hospital of Southern Medical University, Guangzhou, 510282, China.
authors.forename: Nan
authors.initials: N
authors.lastname: Xiang
authors.affiliation: Department of Hepatobiliary Surgery, Zhujiang Hospital of Southern Medical University, Guangzhou, 510282, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of Hepatobiliary Surgery, Zhujiang Hospital of Southern Medical University, Guangzhou, 510282, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Zhu
authors.affiliation: Department of Hepatobiliary Surgery, Zhujiang Hospital of Southern Medical University, Guangzhou, 510282, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Hepatobiliary Surgery, Zhujiang Hospital of Southern Medical University, Guangzhou, 510282, China.
authors.forename: Tianpei
authors.initials: T
authors.lastname: Guan
authors.affiliation: Department of Hepatobiliary Surgery, Zhujiang Hospital of Southern Medical University, Guangzhou, 510282, China.
authors.forename: Cheng
authors.initials: C
authors.lastname: Fang
authors.affiliation: Department of Hepatobiliary Surgery, Zhujiang Hospital of Southern Medical University, Guangzhou, 510282, China.
authors.forename: Fei
authors.initials: F
authors.lastname: Xiang
mesh_terms: D001650:Bile Duct Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D001653:Bile Ducts, Intrahepatic / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D018285:Klatskin Tumor / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D057285:Precision Medicine; D011300:Preoperative Care; D011379:Prognosis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*