Beneficial effects of 3-dimensional visualization on hepatic vein reconstruction in living donor liver transplantation using right lobe graft.
Beneficial effects of 3-dimensional visualization on hepatic vein reconstruction in living donor liver transplantation using right lobe graft.
复制标题
3 维可视化对右叶移植活体肝移植中肝静脉重建的有益影响。
DOI：
10.1097/00007890-200112270-00022
复制
发表时间：
2001
期刊：
影响因子：
6.2
通讯作者：
K. Sugimachi
中科院分区：
文献类型：
--
作者：
S. Hiroshige;Takashi Nishizaki;Y. Soejima;Koji Hashimoto;Ryuji Ohta;Ryousuke Minagawa;M. Shimada;Hiroshi Honda;Makoto Hashizume;K. Sugimachi
背景
最近，虚拟手术计划和导航系统已被引入神经外科和骨科手术领域。我们在这里报告 3 维 (3D) 可视化对使用右叶移植物的活体肝移植 (LDLT) 中肝静脉重建的有益影响。
方法
使用 zioM900（日本东京 Zio Software Inc.）通过 3 毫米螺旋计算机断层扫描 (CT) 数据切片渲染肝脏 3D 图像重建。为了了解供体血管的解剖结构并设计手术计划，重建了肝脏内部和周围血管的图片。
结果
3D 图像显示右下肝静脉 (IRHV) 旁边有两条短肝静脉以及一条大 IRHV。与 2 维 CT 测量的图像相比，3D 图像显示出更精确的右肝静脉 (RHV) 和 IRHV 直径以及两条肝静脉之间的更精确距离。这些术前信息使供体外科医生能够解剖下腔静脉 (IVC) 和肝静脉，同时减少血管损伤的风险，从而减少失血。 3D 图像显示 RHV 和 IRHV 均以相同角度从圆柱形 IVC 分支。基于此信息的术前计划确保了吻合的顺利进行。
结论
3D 可视化对于受者的肝静脉重建以及使用右叶移植物的 LDLT 供体手术非常有用。
BACKGROUND
Recently, virtual operation planning and navigation systems have been introduced in the field of neurosurgery and orthopedic surgery. We report here the beneficial effects of 3-dimensional (3D) visualization on hepatic venous reconstruction in living donor liver transplantation (LDLT) using right lobe graft.
METHODS
3D-image reconstruction of the liver was rendered with 3-mm slices of helical computed tomography (CT) data using zioM900 (Zio Software Inc., Tokyo, Japan). To understand the anatomy of the donor's vessels and design an operation plan, a picture of the vessels in and around the liver was reconstructed.
RESULTS
The 3D image demonstrated two short hepatic veins next to the inferior right hepatic vein (IRHV) as well as a large IRHV. The 3D image showed a more precise diameter of the right hepatic vein (RHV) and the IRHV and a more accurate distance between the two hepatic veins than did images measured by 2-dimensional CT. This preoperative information allowed the donor surgeon to dissect the inferior vena cava (IVC) and hepatic veins with reduced blood loss because of reduced risk of injury to the blood vessels. The 3D image revealed that both the RHV and the IRHV branched off at the same angle from the cylindrical IVC. Preoperative planning based on this information secured smooth anastomosis.
CONCLUSIONS
3D visualization is useful for hepatic venous reconstruction of the recipient as well as for donor surgery in LDLT using right lobe graft.