Application of three-dimensional visualization technology in associating liver partition and portal vein ligation for staged hepatectomy

Abstract

Objective To explore the application value of three-dimensional visualization technology in associating liver partition and portal vein ligation for staged hepatectomy (ALPPS). Methods Clinical data of one patient with hepatocellular carcinoma (HCC) undergoing ALPPS using three-dimensional visualization technology were analyzed retrospectively. The patient was female, aged 44 years, was hospitalized due to transaminase elevation for 3 months and solid hepatic lesion for 3 d. She had a history of hepatitis B. She was diagnosed with massive HCC in the right liver lobe. The informed consents of the patient was obtained and the local ethical committee approval was received. Preoperative evaluation and surgical planning were performed using computer tomography (CT) scan and medical imaging three-dimensional visualization system (MI-3DVS). Results Total liver volume was 1 033 ml and the left lobe volume was 195 ml, accounting for 16% of the standard liver volume measured by three-dimensional visualization technology before the first-stage surgery. The right branch of portal vein was ligated and the left and right liver lobes were separated. Total liver volume was 1 048 ml and the left lobe volume was 394 ml, accounting for 33% of the standard liver volume measured by three-dimensional visualization technology 3 weeks after surgery. Right hemihepatectomy was performed during the second stage. The findings of preoperative three-dimensional visualization technology were consistent with intraoperative observation. Preoperative surgical planning was in accordance with intraoperative procedures. No apparent complication was observed after surgery. Conclusion Three-dimensional visualization technology is a favorable supplementary option for ALPPS in making the preoperative precise diagnosis and detailed surgical planning. Key words: Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS); Imaging, three-dimensional; Liver neoplasms; Operative planning