Application of individualized hepatic segmentation based on CT three-dimensional visualization technology in anatomical hepatectomy

doi:10.3877/cma.j.issn.1674-3946.2025.03.008.

Abstract

Abstract:

Objective

To discuss the application effect of individualized hepatic segmentation using CT three-dimensional visualization technology in patients undergoing anatomical liver resection （LALR）.

Methods

A total of 62 patients with liver cancer from January 2020 to December 2023 were selected and divided into two groups by the random number table method，with 31 patients in each group.All patients underwent LALR.The patients in the observation group received individualized hepatic segmentation surgical planning based on CT three-dimensional visualization technology before the operation； the control group used the traditional method to determine the surgical scope.The statistical software SPSS27.0 was used for statistical analysis of the data.Measurement data such as various perioperative indexes were expressed as（±s），and independent samples t test was performed for comparison； χ² test was performed for counting data indexes such as the incidence of postoperative complications.A P value less than 0.05 was considered statistically significant.

Results

The predicted liver resection volume and the actual resection volume of the patients in the observation group were both smaller than those in the control group （P＜0.05）.The operation time，intraoperative blood loss，length of hospital stay，and intraoperative blood transfusion rate of the patients in the observation group were significantly lower than those in the control group （P＜0.05）.There was no statistically significant difference in the total incidence of postoperative complications between the two groups of patients （9.7% vs. 22.6%，P＞0.05）.During the follow-up from 6 to 18 months after the operation，there were no death cases in both groups.The loss to follow-up rate in the control group was 9.7%，and that in the observation group was 3.2%.The tumor recurrence rate in the observation group was lower than that in the control group （0.0% vs. 21.4%，P＜0.05）.

Conclusion

In LALR，preoperative planning of individualized hepatic segmentation using CT-based three-dimensional visualization technology helps to reduce intraoperative blood loss，shorten the operation time and the length of hospital stay，improve the accuracy of the operation，and is helpful in reducing the risk of tumor recurrence.

Key words: Liver Neoplasms, Laparoscopes, Laparoscopic Anatomic Liver Resection, Computed Tomography, Imaging,Three-Dimensional, Personalized Liver Segment

Haitao Sheng, Mingrui Dou, Junjie Wang, Xiaolong Xiu, Jianmao Yang, Changcheng Dong. Application of individualized hepatic segmentation based on CT three-dimensional visualization technology in anatomical hepatectomy[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(03): 258-261.

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https://zhpwkssxzz.cma-cmc.com.cn/EN/Y2025/V19/I03/258

Figures/Tables 9

组别	例数	性别（例）	年龄　（岁， $\overset{ˉ}{x}$ ±s）	肿瘤直径　（cm， $\overset{ˉ}{x}$ ±s）	BMI（kg/m²， $\overset{ˉ}{x}$ ±s）
组别	例数	男/女	年龄　（岁， $\overset{ˉ}{x}$ ±s）	肿瘤直径　（cm， $\overset{ˉ}{x}$ ±s）	BMI（kg/m²， $\overset{ˉ}{x}$ ±s）
观察组	31	8/23	56. 7±11. 4	4. 2±0. 7	20. 9±2. 4
对照组	31	5/26	54. 9±14. 5	4. 0±0. 9	21. 1±1. 7
χ ² t/z值		0. 876	0. 543	0. 977	0. 379
P值		0. 349	0. 589	0. 333	0. 706
组别	例数	Child分级（例）	肿瘤位置（例）	HBsAg（例）
组别	例数	A/B	左/右	阳性/阴性
观察组	31	30/1	8/23	12/19
对照组	31	29/2	11/20	14/17
χ ² t/z值		0. 557	0. 683	0. 265
P值		0. 587	0. 409	0. 607

组别	例数	性别（例）	年龄　（岁， $\overset{ˉ}{x}$ ±s）	肿瘤直径　（cm， $\overset{ˉ}{x}$ ±s）	BMI（kg/m²， $\overset{ˉ}{x}$ ±s）
组别	例数	男/女	年龄　（岁， $\overset{ˉ}{x}$ ±s）	肿瘤直径　（cm， $\overset{ˉ}{x}$ ±s）	BMI（kg/m²， $\overset{ˉ}{x}$ ±s）
观察组	31	8/23	56. 7±11. 4	4. 2±0. 7	20. 9±2. 4
对照组	31	5/26	54. 9±14. 5	4. 0±0. 9	21. 1±1. 7
χ ² t/z值		0. 876	0. 543	0. 977	0. 379
P值		0. 349	0. 589	0. 333	0. 706
组别	例数	Child分级（例）	肿瘤位置（例）	HBsAg（例）
组别	例数	A/B	左/右	阳性/阴性
观察组	31	30/1	8/23	12/19
对照组	31	29/2	11/20	14/17
χ ² t/z值		0. 557	0. 683	0. 265
P值		0. 587	0. 409	0. 607

组别	例数	手术时间　（min， $\overset{ˉ}{x}$ ±s）	术中出血量　（ml， $\overset{ˉ}{x}$ ±s）	预计切除体积（ml， $\overset{ˉ}{x}$ ±s）
观察组	31	186.3±19.4	187. 5±26. 1	451. 2±42. 3
对照组	31	204. 0±23. 1	244. 2±30. 6	568. 5±33. 8
χ ²/t值		3. 267	7. 849	12. 062
P值		0. 002	＜0. 001	＜0. 001
组别	例数	实际切除体积（ml， $\overset{ˉ}{x}$ ±s）	住院时间　（d， $\overset{ˉ}{x}$ ±s）	术中输血　［例（%）］
观察组	31	436. 6±34. 2	7. 2±1. 6	3（9. 68）
对照组	31	471. 5±36. 3	9. 4±2. 2	11（35. 48）
χ ²/t值		3. 896	4. 503	5. 905
P值		＜0. 001	＜0. 001	0. 015

组别	例数	手术时间　（min， $\overset{ˉ}{x}$ ±s）	术中出血量　（ml， $\overset{ˉ}{x}$ ±s）	预计切除体积（ml， $\overset{ˉ}{x}$ ±s）
观察组	31	186.3±19.4	187. 5±26. 1	451. 2±42. 3
对照组	31	204. 0±23. 1	244. 2±30. 6	568. 5±33. 8
χ ²/t值		3. 267	7. 849	12. 062
P值		0. 002	＜0. 001	＜0. 001
组别	例数	实际切除体积（ml， $\overset{ˉ}{x}$ ±s）	住院时间　（d， $\overset{ˉ}{x}$ ±s）	术中输血　［例（%）］
观察组	31	436. 6±34. 2	7. 2±1. 6	3（9. 68）
对照组	31	471. 5±36. 3	9. 4±2. 2	11（35. 48）
χ ²/t值		3. 896	4. 503	5. 905
P值		＜0. 001	＜0. 001	0. 015

组别	例数	腹腔出血	胆瘘	胸/腹水	肝功能衰竭	总并发症
观察组	31	1（3. 2）	1（3. 2）	1（3. 2）	0（0. 0）	3（9. 7）
对照组	31	4（12. 9）	0（0. 0）	2（6. 5）	1（3. 2）	7（22. 6）
χ ² 值		-	-	-	-	1. 908
P值		-	-	-	-	0. 167

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