三维重建联合3D打印辅助微创手术治疗肝胆管结石的疗效及预后分析

Curative efficacy and pronosis of three-dimensional reconstruction combined with 3D printing assisted minimally invasive surgery in the treatment of hepatolithiasis

目的分析三维重建联合3D打印辅助微创手术治疗肝胆管结石的疗效及预后。方法回顾性收集2018年11月至2020年1月山东第一医科大学附属青岛医院收治的92例接受微创手术治疗的复杂肝胆管结石患者,根据手术定位方式的不同分为对照组50例(常规CT定位)和观察组42例(三维重建联合3D打印技术辅助定位)。比较两组患者疗效、结石残留率、手术相关指标、并发症及复发率。结果观察组疗效评价中的优良率高于对照组(95.2%vs 80.0%),术后结石残留率低于对照组(4.0%vs 22.0%,P均<0.05)。与对照组相比,观察组手术时间缩短,术中出血量、术后腹腔引流量减少,术后腹腔引流时间和住院时间缩短(P均<0.05)。观察组术后并发症发生率和复发率均低于对照组(11.9%vs 30.0%,2.4%vs 18.0%,P均<0.05)。结论三维重建联合3D打印辅助微创手术治疗复杂肝胆管结石效果良好,能够减少复发率。

Objective To analyze curative efficacy and pronosis of three-dimensional reconstruction combined with 3D printing assisted minimally invasive surgery in the treatment of hepatolithiasis.Methods 92 patients with complex hepatolithiasis treated by minimally invasive surgery in Qingdao Hospital affiliated to Shandong First Medical University from November 2018 to January 2020 were retrospectively selected.According to different surgical positioning methods,they were divided into the control group[50 cases,conventional computer tomography(CT)positioning]and the observation group(42 cases,3D reconstruction combined with 3D printing technology).The curative effect,stone residue rate,operation related indexes,complications and recurrence rate were compared between the two groups.Results The excellent and good rate of the observation group was higher than that of the control group(95.2%vs 80.0%),and the rate of residual stones after surgery was lower than that of the control group(4.0%vs 22.0%),with statistically significant difference(both P<0.05).Compared with the control group,the observation group had shorter operation time,less intraoperative blood loss and postoperative abdominal drainage volume,shorter postoperative abdominal drainage time and hospital stay,with statistically significant difference(all P<0.05).The incidence of postoperative complications and recurrence rate in the observation group were lower than those in the control group(11.9%vs 30.0%,2.4%vs 18.0%),with statistically significant difference(both P<0.05).Conclusions Three-dimensional reconstruction combined with 3D printing assisted minimally invasive surgery is effective in the treatment of complex hepatolithiasis and can reduce the recurrence rate.