Clinical study of CT scanning 3D reconstruction in laparoscopic hepatectomy for intrahepatic cholangiocarcinoma

doi:10.3877/cma.j.issn.1674-3946.2025.01.028.

Abstract

Abstract:

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.

Key words: Intrahepatic Cholangiocarcinoma, Laparoscopes, Hepatectomy, Computed Tomography, Three-Dimensional Reconstruction

Wang Feng, Zhenzhong Ma, Linhua Tang. Clinical study of CT scanning 3D reconstruction in laparoscopic hepatectomy for intrahepatic cholangiocarcinoma[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(01): 104-107.

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Figures/Tables 4

组别	例数	性别（例）男/女	年龄（岁， $\overset{ˉ}{x}$ ±s）	BMI（kg/m²， $\overset{ˉ}{x}$ ±s）	肝炎病史（例）有/无
对照组	50	28/22	56.1±8.1	23.1±3.2	37/13
研究组	46	25/21	57.4±8.3	22.8±3.1	30/16
t/χ²/Z值		0.026	0.776	0.466	0.877
P值		0.871	0.220	0.321	0.349
组别	例数	肿瘤长径（cm， $\overset{ˉ}{x}$ ±s）	肿瘤数目（例）单发/多发	Child-Pugh分级（例）A/B	肿瘤分期（例）Ⅰ/Ⅱ/Ⅲ
对照组	50	4.2±1.0	35/15	38/12	19/23/8
研究组	46	4.1±1.1	33/13	31/15	14/25/7
t/χ²/Z值		0.467	0.035	0.878	-0.543
P值		0.321	0.851	0.349	0.587

组别	例数	性别（例）男/女	年龄（岁， $\overset{ˉ}{x}$ ±s）	BMI（kg/m²， $\overset{ˉ}{x}$ ±s）	肝炎病史（例）有/无
对照组	50	28/22	56.1±8.1	23.1±3.2	37/13
研究组	46	25/21	57.4±8.3	22.8±3.1	30/16
t/χ²/Z值		0.026	0.776	0.466	0.877
P值		0.871	0.220	0.321	0.349
组别	例数	肿瘤长径（cm， $\overset{ˉ}{x}$ ±s）	肿瘤数目（例）单发/多发	Child-Pugh分级（例）A/B	肿瘤分期（例）Ⅰ/Ⅱ/Ⅲ
对照组	50	4.2±1.0	35/15	38/12	19/23/8
研究组	46	4.1±1.1	33/13	31/15	14/25/7
t/χ²/Z值		0.467	0.035	0.878	-0.543
P值		0.321	0.851	0.349	0.587

组别	例数	手术时间（min， $\overset{ˉ}{x}$ ±s）	出血量（ml， $\overset{ˉ}{x}$ ±s）	肝切除体积（cm³， $\overset{ˉ}{x}$ ±s）	切缘阳性率［例（%）］
对照组	50	235.3±40.6	445.4±68.8	414.8±34.5	6（12.0）
研究组	46	214.8±34.5	376.3±56.5	403.1±30.1	0（0.0）
t/χ²值		2.654	5.371	1.763	4.018
P值		0.005	0.000	0.041	0.045
组别	例数	肛门初次排气时间（d， $\overset{ˉ}{x}$ ±s）	引流管留置时间（d， $\overset{ˉ}{x}$ ±s）	术后住院时间（d， $\overset{ˉ}{x}$ ±s）
对照组	50	2.6±0.7	6.3±1.7	10.4±2.1
研究组	46	2.3±0.6	5.7±1.5	9.7±1.9
t/χ²值		2.245	1.827	1.707
P值		0.014	0.035	0.046

组别	例数	手术时间（min， $\overset{ˉ}{x}$ ±s）	出血量（ml， $\overset{ˉ}{x}$ ±s）	肝切除体积（cm³， $\overset{ˉ}{x}$ ±s）	切缘阳性率［例（%）］
对照组	50	235.3±40.6	445.4±68.8	414.8±34.5	6（12.0）
研究组	46	214.8±34.5	376.3±56.5	403.1±30.1	0（0.0）
t/χ²值		2.654	5.371	1.763	4.018
P值		0.005	0.000	0.041	0.045
组别	例数	肛门初次排气时间（d， $\overset{ˉ}{x}$ ±s）	引流管留置时间（d， $\overset{ˉ}{x}$ ±s）	术后住院时间（d， $\overset{ˉ}{x}$ ±s）
对照组	50	2.6±0.7	6.3±1.7	10.4±2.1
研究组	46	2.3±0.6	5.7±1.5	9.7±1.9
t/χ²值		2.245	1.827	1.707
P值		0.014	0.035	0.046

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