数字化微创技术在精准肝胆管结石的应用

The Application of Digital Minimally Invasive Techniques in Accurate of Bile Duct Stones

目的:探索数字医学技术在肝胆管结石术前评估及降低术后残石率的应用价值。方法:采集2008年8月至2011年8月在南方医科大学珠江医院肝胆一科收治的100例肝胆管结石病人的肝脏64排螺旋CT扫描原始数据,对数据进行处理后,运用自主研发的腹部医学图像三维可视化系统(MI-3DVS,medical imaging three dimensional visual system)进行三维重建,仿真手术过程评估手术预案可行性及安全性,指导临床实际手术过程;最后根据术中情况及术后恢复综合评价三维重建及仿真可视化技术应用价值。结果:当肝脏设置为半透明时,可以清晰显示肝内、外胆管结石的大致位置、个数及肝内、外胆管的扩张和狭窄情况。仿真手术接近实际操作。患者仿真手术结果显示结石无残留,达到理想的手术效果。结论:利用MI-3DVS系统可有效降低术后残石率、提高手术成功率,真正实现了手术的精准性。

Objective： Exploring the application value of digital medical technology in hepatic calculus preoperative evaluation and reducing the remaining calculus in the intrahepatic duct stone. Methods： Data of hepatic veins on 64-row helical CT scanning of 100 patients from Aug. 2008 to Oct. 2011 were collected. 3D reconstruction based on segmentation data was applied by Abdomen medical image 3D visualization system （ AMI-3DVS ） which is a self- designed software. The feasibility and security were evaluated by the simulation of operation. Medical imaging three dimensional visual system and emulation technology were evaluated by the surgical situation and postoperative recovery. Results When the liver Settings for translucent, it can clearly show the site and the number of the bile duct calculus, the intrahepatic bile duct expansion or narrow. Simulation surgery was closed to actual operation. Simulation operation results showed that stone was no residual. Conclusions： It can effectively reduce the rate of postoperative residual stones, improve the success rate of operation and fulfill the surgical precision with MI-3DVS.