Published online Aug 27, 2023. doi: 10.4240/wjgs.v15.i8.1693
Peer-review started: April 11, 2023
First decision: April 26, 2023
Revised: May 5, 2023
Accepted: June 13, 2023
Article in press: June 13, 2023
Published online: August 27, 2023
Processing time: 136 Days and 10.8 Hours
The incidence of hilar cholangiocarcinoma (HCCA) has shown a significant upward trend, and radical surgery is an effective treatment. However, the complexity of the anatomical structure of the hilar bile duct and blood vessels, the invasion of the adjacent blood vessels of the tumor, jaundice, and the scope of hepatectomy have resulted in a low resection rate for HCCA and poor prognosis.
The preoperative evaluation of HCCA mainly relies on traditional computed tomography and magnetic resonance imaging. Surgeons need to construct 2D images into 3D models in their minds based on clinical experience and anatomical knowledge. Such a method is subjective and will affect the formulation of surgical plans.
This study aimed to establish a laparoscopic precise resection of HCCA based on preoperative eOrganmap 3D reconstruction and full quantification technology, to provide a new method for precise treatment of HCCA.
We retrospectively analyzed the clinical data of 73 patients with HCCA who underwent surgery. Patients were divided into the traditional group (2D imaging planning before surgery) and eOrganmap group (3D reconstruction and full quantification technology planning before surgery). To compare the relevant indicators of the two groups of patients and to further explore the difference between eOrganmap 3D reconstruction and full quantification technology and traditional 2D image planning treatment.
eOrganmap 3D reconstruction and full quantification technology planning have obvious advantages in classification accuracy, blood loss, operating time, postoperative intestinal ventilation time, R0 resection rate, number of lymph nodes dissected, total complication rate, and liver function. In the eOrganmap group, there was a high correlation between the volume of the actual resected liver specimen and the volume of the virtual resected liver specimen before the operation.
Establishing laparoscopic precise resection of hilar cholangiocarcinoma based on preoperative eOrganmap 3D reconstruction and full quantification technology can make laparoscopic HCCA resection more accurate and safe.
The results of this study were verified by a retrospective study with a large sample size, which enhanced the reliability of the results and contributed to the clinical promotion of eOrganmap 3D reconstruction and full quantification technology.