title: Clinical Applications of Three-Dimensional Visualization Model of Arteries Supplying the Extrahepatic Bile Duct for Patients with Biliary Obstruction.
abstract: This study aimed to assess distribution characteristics and digital typing of arteries supplying the extrahepatic bile duct for patients with biliary obstruction, and evaluate the three-dimensional (3D) model in surgical decision-making. Forty-one patients with biliary obstruction were retrospectively evaluated. Clinical data obtained by 64-slice multidetector CT angiography scanning were introduced into Medical Image Three-Dimensional Visualization System; then, 3D model of extrahepatic bile duct and its supplying arteries were reconstructed. Based on the 3D model, the origination and bifurcations of the bile duct artery were observed, and the digital types established. Afterwards, plans for preoperative procedures were formulated. Finally, postoperative observations were performed and the biliary complications recorded in detail. The 3D model clearly displayed the origin, course, and distribution of individualized arteries supplying the extrahepatic bile duct, as well as variations. According to 3D model characteristics, the digital types were established. Blood supply to the superior segment of the extrahepatic bile duct encompassed 6 (14.6%), 17 (41.5%), 12 (29.3%), and 6 (14.6%) cases of Types IA, IB, IC, and II, respectively; meanwhile, blood supply to the inferior segment comprised 13 (31.7%), 13 (31.7%), 4 (9.8%), 7 (17.0%), and 4 (9.8%) cases of Types IA, IB, IC, II, and III, respectively. This classification helped in preoperative surgical planning and corroborated intraoperative findings. No postoperative biliary complications were recorded. The 3D model reconstructed using Medical Image Three-Dimensional Visualization System displayed individualized anatomical structures of the extrahepatic bile duct and associated blood supplying arteries, and could contribute to preoperative surgical planning.
authors.affiliation: Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, Guangdong, People's Republic of China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Jian
authors.forename: Tao
authors.initials: T
authors.lastname: Haisu
authors.forename: Fang
authors.initials: F
authors.lastname: Chihua
authors.forename: Fan
authors.initials: F
authors.lastname: Yingfang
authors.forename: Xiang
authors.initials: X
authors.lastname: Nan
authors.forename: Zeng
authors.initials: Z
authors.lastname: Ning
authors.forename: Liu
authors.initials: L
authors.lastname: Jun
authors.forename: Zhu
authors.initials: Z
authors.lastname: Wen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods; D001158:Arteries / Q000000981:diagnostic imaging*; D017734:Bile Ducts, Extrahepatic / Q000098:blood supply* / Q000000981:diagnostic imaging; D042883:Choledocholithiasis / Q000000981:diagnostic imaging / Q000601:surgery; D002779:Cholestasis / Q000000981:diagnostic imaging* / Q000601:surgery; D004386:Duodenum; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008488:Medical Illustration; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D059351:Organ Sparing Treatments; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging