The Journal of Practical Medicine ›› 2023, Vol. 39 ›› Issue (12): 1546-1550.doi: 10.3969/j.issn.1006⁃5725.2023.11.015

• Clinical Research • Previous Articles     Next Articles

Clinical application value of terminal branches portal vein embolization and multimode imaging technolo⁃ gy in precise hepatectomy of huge hepatocellular carcinoma 

LIU Wenying,QUE Yuan,OUYANG Zaixing, ZHU Jianhua,WU Liming,TAN Yong,SONG Hao,ZHU Yuzhen,HUANG Congyun.   

  1. Department of Hepatobiliary Surgery,Yuebei People′s Hospital of Shantou University,Shaoguan,Guangdong 512025,China 
  • Online:2023-06-25 Published:2023-06-25
  • Contact: LIU Wenying E⁃mail:liuwy_dr@163.com

Abstract:

Objective To evaluate the clinical application of the terminal branches portal vein emboliza⁃ tion and multimode imaging technology in precise hepatectomy for patients with huge hepatocellular carcinoma. Methods Clinical data of 52 patients of huge hepatocellular carcinoma underwent precise hepatectomy with the help of multimode imaging technology in Yuebei People′s Hospital between Feb. 2018 and Nov. 2021 were retrospec⁃ tively analyzed. According to the treatment method,the patients were divided into direct surgical resection group (control group,27 cases). And terminal branches portal vein embolization followed by surgical resection group (study group,25 cases). The multimode imaging technology fusing three⁃dimensional reconstruction which convert⁃ ed from CT imaging,three⁃dimensional visualization,three dimensional printing and augmented reality in assess⁃ ing the hepatic anatomy,instructing preoperative planning and navigating operation. The terminal branches portal vein embolization technology blocked the interconnected portal vein of the two sides of the liver,and promoted the future liver remnant before surgery. Perioperative results and postoperative efficacy of the two groups such as the surgical methods,operative time,intraoperative blood loss,and postoperative complications were observed and analyzed. Results The multimode imaging technology were successfully applied in all 52 patients,achieved satis⁃ fying preoperative assessment,surgical planning,and intraoperative navigation. The future liver remnant of patients in the study group were promoted effectively,(93 ~ 322 mL,media183 mL). All patients underwent surgery suc⁃ cessfully,there were none perioperative death,no serious postoperative complications such as bleeding,biliary leakage and liver failure occurred. The hepatic blood flow occlusion time,intraoperative blood loss,postoperative length of stay and the incidence of postoperative complications of the study group were(27.6 ± 11.6)min,236 (100)mL,(10.8 ± 2.4)d,12.0%(3/25),respectively. Significantly less than which in the control group(34.4 ± 10.9 min,292(150)mL,(13.1 ± 4.1)d,37.0%(10/27)(P < 0.05). The operative time were(209.6 ± 36.5)min and(237.0 ± 69.1)min in the control group respectively,there was no significant difference(P > 0.05). There were 5 and 11 cases of recurrence respectively in two groups,but no statistical difference between two groups (χ2 = 0.735,P > 0.05). Conclusion The terminal branches portal vein embolization and multimode imaging tech⁃ nology can improve the safety and effect of precise hepatectomy for patients with huge hepatocellular carcinoma through augmented the future liver remnant,accurate preoperative planning and surgical navigation. 

Key words: huge hepatocellular carcinoma, terminal branches portal vein embolization, three dimen? sional visualization, three dimensional printing, augmented reality, precise hepatectomy