Outcomes of reoperation for hepatolithiasis with 3D imaging individualized preoperative planning technique: a single-center experience.
Minerva Surg
; 76(1): 62-71, 2021 02.
Article
em En
| MEDLINE
| ID: mdl-32773735
ABSTRACT
BACKGROUND:
A detailed assessment of biliary tract anatomy is necessary for the successful reoperation for hepatolithiasis. This study aimed to evaluate the feasibility of preoperative individualized surgical planning with three-dimensional (3D) imaging technique for reoperation of hepatolithiasis.METHODS:
This was a retrospective matched case-control study. From January 2011 to December 2018, 56 patients receiving reoperation according to the individualized preoperative plan based on 3D imaging at our center were included (group A). Meanwhile, 54 patients receiving traditional imaging guided reoperation matched by age, gender and distribution of hepatobiliary stones to each case were selected as controls (group B). The perioperative and long-term follow-up outcomes were compared between the two groups.RESULTS:
There was no significant difference in demographic characteristics between groups. Compared with group B, the group A had a significantly shorter operation time (245.7±56.2 min vs. 305.2±79.9 min, P<0.001), a significantly higher surgical plan implementation rate (SPIR, 92.9% vs. 66.7%, P=0.001) and a lower incidence-of severe complications (Clavien-Dindo grade>II, 1.8% vs. 14.8%, P=0.015). The incidences of initial residual stone (7.1% vs. 44.4%, P<0.001) and repeated cholangitis (3.6% vs. 33.3%, P<0.001) were significantly lower in group A than in group B. After postoperative choledochoscopic lithotripsy, the incidence of final residual stones was significantly lower in group A than in group B. (1.8% vs. 20.4%, P=0.002).CONCLUSIONS:
The preoperative 3D imaging assisted surgical planning is feasible and safe for reoperation of hepatolithiasis which can effectively improve surgical plan implementation rate and reduce the incidence of postoperative complications as compared with conventional surgical planning.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Litíase
/
Hepatopatias
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
Minerva Surg
Ano de publicação:
2021
Tipo de documento:
Article