论文部分内容阅读
目的研究计算机辅助手术系统在小儿先天性胆管扩张症诊断与治疗中的应用价值。方法回顾性分析2013年6月至2015年1月青岛大学附属医院收治的25例先天性胆管扩张症患儿的肝脏64排螺旋CT扫描原始数据,采用计算机辅助手术系统(Hisense CAS)进行肝脏及胆道三维重建,根据三维重建结果进行精准的术前诊断和病理形态分析,以及辅助手术规划,确定最佳手术方案。观察术中所见与术前规划的符合程度、术中出血量、并发症等。结果 25例中,囊肿型14例,梭状型11例;合并肝内胆管扩张18例;少见的复杂胆道畸形3例。肝脏及其内部管道系统的三维模型形态逼真、立体感强,清晰地显示胆管的分布走形及其与肝内三套血管系统的空间位置关系。术前手术方案与实际手术方式符合率为88%(22/25)。术中出血量中位数为12 mL,最少出血量为6 mL。术后无一例出现严重并发症或死亡。结论通过计算机辅助手术系统对CT数据进行三维重建,实现了胆道系统的数字化解剖,并能清晰显示胆道及其周围血管系统的空间位置关系,提高先天性胆管扩张症手术的精准性和手术安全性。
Objective To study the value of computer-assisted surgery in the diagnosis and treatment of congenital bile duct dilatation in children. Methods The raw data of 64-slice spiral CT in 25 children with congenital bile duct dilatation admitted to Qingdao University Affiliated Hospital from June 2013 to January 2015 were retrospectively analyzed. Hisense CAS was used to detect liver and Three-dimensional reconstruction of biliary tract, according to the results of three-dimensional reconstruction of accurate preoperative diagnosis and pathological analysis, and assisted surgical planning to determine the best surgical options. Observation of intraoperative findings and preoperative planning compliance, intraoperative bleeding, complications and so on. Results Among the 25 cases, 14 cases were cyst type and 11 cases were shuttle type. There were 18 cases with intrahepatic bile duct dilation and 3 cases with rare complicated biliary malformations. The three-dimensional model of the liver and its internal pipeline system is vivid in shape and strong in three-dimension, which clearly shows the distribution of the bile duct and its spatial relationship with the three intrahepatic vascular systems. The preoperative surgical plan and the actual surgical method coincide rate was 88% (22/25). The median blood loss was 12 mL and the minimum amount of bleeding was 6 mL. None of the patients had any serious complications or death after surgery. Conclusion Three-dimensional reconstruction of CT data by computer-aided surgery system can realize the digital anatomy of biliary tract, and can clearly display the spatial relationship between the biliary tract and its peripheral vascular system, and improve the accuracy and safety of surgical treatment of congenital bile duct dilatation .