目的

研究CT扫描三维重建在肝内胆管细胞癌（ICC）腹腔镜肝切除术（LH）中的临床效果。

方法

回顾性选取2021年1月至2023年6月基于CT扫描三维重建行LH的ICC患者46例为研究组，另选择同期基于常规CT检查行LH的ICC患者50例为对照组。数据分析采用SPSS 25.0完成，围手术期各指标、肝功能指标等计量资料用（x± s）表示，行独立样本t检验；术后并发症、肝功能损伤程度等计数资料用［例（%）］表示，行χ²或秩和检验；生存分析用Kaplan-Meier法行Log-Rank检验。P＜0.05为差异有统计学意义。

结果

研究组患者手术时间、出血量、肝切除体积、术后病理切缘阳性率、肛门初次排气时间、引流管留置时间及术后住院时间较对照组均显著降低（P＜0.05）；研究组的肝功能损伤程度显著低于对照组，差异具有统计学意义（P＜0.05）；研究组患者术后并发症的总发生率（8.7%）与对照组（24.0%）对比，差异具有统计学意义（P＜0.05）；研究组患者累积无病生存期（DFS）显著高于对照组（87.0%vs.70.0%），差异有统计学意义（Log-Rankχ²=3.894，P=0.046）；两组患者累积总生存期（OS）比较（89.1%vs.74.0%），差异无统计学意义（Log-Rankχ²=2.983，P=0.084）。

结论

CT扫描三维重建在ICC患者LH中的临床效果显著，不仅有效缩短了手术时间，减少术中损伤，还可减轻患者肝功能损伤程度，降低术后并发症发生风险，提高手术的精准性和安全性，降低切缘阳性率，改善患者预后。

Objective

To investigate the clinical effect of CT scanning 3D reconstruction in laparoscopic hepatectomy （LH） for intrahepatic cholangiocarcinoma （ICC）.

Methods

A total of 46 ICC patients who underwent LH based on CT scanning 3D reconstruction from January 2021 to June 2023 were retrospectively selected as the study group， and 50 ICC patients who underwent LH based on routine CT examination during the same period were selected as the control group.SPSS 25.0 was used to complete the data analysis.Perioperative indicators， liver function indicators and other measurement data were represented with （x ± s），and independent sample t test was performed.The statistical data of postoperative complications and degree of liver function injury were expressed by［ cases （%）］ and χ² or Rank Sum test was performed.Survival analysis was tested using Kaplan-Meier method and Log-Rank test.P＜0.05 was considered statistically significant.

Results

The operative time， blood loss， volume of liver resection， positive rate of postoperative pathological margin， primary anal exhaust time， drainage tube indentation time and postoperative hospital stay in the study group were significantly reduced compared with the control group （P＜0.05）.The degree of liver function injury in the study group was significantly lower than that in the control group， the difference was statistically significant （P＜0.05）.The total incidence of postoperative complications in the study group （8.7%） was significantly higher than that in the control group （24.0%） （P＜0.05）.The cumulative disease-free survival（DFS） of the study group was significantly higher than that of the control group （87.0% vs.70.0%）， and the difference was statistically significant （Log-Rankχ²=3.894， P=0.046）.There was no significant difference in cumulative overall survival （OS） between the two groups （89.1% vs.74.0%） （Log-Rankχ²=2.983， P=0.084）.

Conclusion

The clinical effect of three-dimensional reconstruction of CT scan in ICC patients with LH is significant， which not only effectively reduces the operation time and intraoperative injury， but also reduces the degree of liver function injury of patients， reduces the risk of postoperative complications， improves the accuracy and safety of surgery， reduces the positive rate of resection margin， and improves the prognosis of patients.