三维可视化技术在中段胰腺切除术的临床应用

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1、·1338·中华实验外科杂志2010年9月第27卷第9期ChinJExpSurg，September2010，Vo1．27No．9，·临床研究·三维可视化技术在中段胰腺切除术的临床应用范应方方驰华项楠杨剑陈智翔苏仲和【摘要】目的探讨三维可视化(Three—dimensionalVisualization)技术在中段胰腺切除术(MP)的临床应用价值。方法采集3例胰腺颈部或体部肿瘤患者原始64层螺旋CT数据，导人三维重建可视化软件一腹部医学图像处理系统(MIPS)中，三维重建出胰腺及其肿瘤、胰周血管以及肝脏、脾脏等脏器。根据三维重建图像，观察肿瘤与周围脏器的空间解剖关系，设计手术入

2、路，指导术中操作。结果MIPS顺利三维重建出3例患者胰腺及肿瘤以及周围脏器和血管，清晰显示肿瘤与周围脏器和血管的空间解剖关系。根据三维重建结果设计手术方案和人路，指导术中操作，2例行开腹中段胰腺切除术MP，1例行腹腔镜下MP，手术顺利，无手术并发症。结论三维可视化技术对胰腺个体化手术方案的设计具有重要指导意义，可进一步扩大应用到MP以外的腹部外科手术。【关键词】三维可视化；胰腺；胰腺切除术Clinicalapplicationofthree-dimensionalvisualizationtechnologyinmiddlepancreatectomyFANYing-fang，

3、FANGChi—huan，XIANGNan，YANGJian，CHENZhi—xiang，SUZhong一e．FirstDepartmentofHepatobiliarySurgery，ZhujiangHospitalofSouthernMedicalUniversity，Guangzhou510282，ChinaCorrespondingauthor：FANGChi—hua，EmaiZ：fangch_dr@126．con【Abstract】ObjectiveToevaluatetheclinicaleffectofthree—dimensionalvisualizationt

4、echnologyinmiddlepancreatectomy(MP)．MethodsTheoriginalimagedataof64-slicespiralCTwereobtainedfrom3patientswithtumorintheneckorbodyofthepancreas．Datawereimpotedinthemedicalimageproceedingsystem(MIPS)whichwasdesignedbyUS．Thenpancrea，pancreatictumor，vascularsystemandotherorgansaroundthepancreas

5、ewerethree—dimensionallyreconstructed．Byobservingthespatialan—atomicalrelationshipbetweentumorandsurroundingorgansorbloodvessels，surgicalapproachwasde—signedtoguideoperation．ResultsUsingMIPS，thepancreas，tumos，surroundingorgansandbloodves—selsin3patientswerethree—dimensionallyreconstructedsuc

6、cessfuHy，andthese3Dpicturescouldclearlyshowthespatialanatomyoftumorandsuroundingorgansbyvisualizationtechniques．Accordingtothere—suhsofthree—dimensionalreconstruction，twopatientswereperformedmiddlepancreatectomysuccessfullywithopenoperation，andonepatientwasperformedlaparoscopicmiddlepancreat

7、ectomysuccessfully．Nopostoperativecomplicationssuchasbleeding，pancreaticleakageordiabeteswereobserved．ConclusionThree—dimensionalreconstructionandvisualizationtechnologyhavegreatpotentialvaluesfordesigningindi—vidualizedpancreaticsurgery，anditcanfu