三维重建联合彩色打印辅助腹腔镜与胆道镜联合治疗复杂肝胆管结石病的疗效分析

Three-dimensional CT reconstruction combined with three-dimensional color printing compared with conventional imaging technology in treatment of complex hepatolithiasis using laparoscopy and choledochoscopy

目的分析CT三维重建联合彩色3D打印技术辅助腹腔镜与胆道镜联合治疗复杂肝胆管结石病的临床疗效。方法回顾分析2019年1月至12月在青岛市城阳区人民医院、青岛大学附属青岛市市立医院和青岛大学附属医院接受腹腔镜与胆道镜联合手术治疗的128例复杂肝胆管结石病患者临床资料,其中男性58例,女性70例,平均年龄41.6岁。按术前评估不同分为观察组(n=62):采用CT三维重建联合彩色3D打印技术;对照组(n=66):采用传统影像学技术(彩超、CT、MRI、磁共振胰胆管成像)。比较两组手术时间、术中出血量、肝门阻断时间、结石清除率、术后并发症和复发情况。结果观察组手术时间、术中出血量、肝门阻断时间、住院时间、治疗费用方面均优于对照组,差异有统计学意义(均P<0.05)。观察组结石清除率96.8%(60/62),优于对照组86.4%(57/66),差异有统计学意义(P<0.05)。观察组术后并发症发生率3.2%(2/62),低于对照组18.2%(12/66),差异有统计学意义(P<0.05)。两组复发率比较差异均无统计学意义(均P>0.05)。结论CT三维重建联合彩色3D打印技术辅助复杂肝胆管结石手术治疗可明显提高结石清除率,减少术后并发症,减轻患者经济负担。

Objective To study the efficacy of three-dimensional(3D)CT reconstruction combined with 3D color printing compared with traditional imaging technology in treatment of complex hepatobiliary calculi treated with laparoscopy and choledochoscopy.Methods A retrospective study was conducted on 128 patients with complex hepatobiliary calculi who underwent hepatobiliary surgery at the Qingdao Chengyang People’s Hospital,Qingdao Municipal Hospital Affiliated to Qingdao University and Qingdao University Affiliated Hospital from January 2019 to December 2019.A comparison was made between patients who underwent three-dimensional CT reconstruction combined with 3D color printing(the study group,n=62)and the traditional imaging technology group(the control group,n=66)on operation time,intraoperative blood loss,liver blood flow occlusion time,stone clearance rate,postoperative complication rate,and recurrence of calculi after operation.Results The study group was significantly better than the control group in operation time,intraoperative blood loss,porta hepatis occlusion time,hospital stay and treatment cost(all P<0.05).The stone clearance rate of the study group was 96.8%(60/62),which was significantly higher than that of the control group(86.4%,57/66)(P<0.05).The incidence of postoperative complications in the study group was 3.2%(2/62),which was significantly lower than that in the control group(18.2%,12/66)(P<0.05).There was no significant difference in the stone recurrence rate between the two groups(all P>0.05).Conclusion Three-dimensional CT reconstruction combined with 3D color printing contributed significantly to the surgical treatment of complex intrahepatic bile duct stones as these imaging technologies significantly improved surgical accuracy,improved stone clearance and reduced postoperative complication rates,and reduced surgical treatment costs.