三维可视化技术在腹腔镜胰体尾囊性肿瘤切除中的.pdfVIP

·1648 · doi 10.3969/j.issn. 1673-4254.2013.11.18 J South Med Univ, 2013, 33(11): 1648-1651 临床研究 三维可视化技术在腹腔镜胰体尾囊性肿瘤切除中的临床应用三维可视化技术在腹腔镜胰体尾囊性肿瘤切除中的临床应用 侯宝华，崔 鹏，简志祥，李少杰，陈 伟，区应亮，区金锐 广东省医学科学院//广东省人民医院普外一区，广东 广州 510080 摘要：目的探讨三维可视化技术对腹腔镜胰体尾部囊性肿瘤切除的应用价值。方法 对2009 年12月~2011 年3 月收治的6 例 胰体尾部囊性肿瘤患者的临床资料进行回顾性分析。采集全部患者的64 排螺旋CT 的原始扫描数据集，通过自适应区域生长 算法对CT 序列图像进行图像程序分割和自动提取，再采用方驰华教授研发的图像处理软件对图像数据进行三维重建，根据重 建的图形制定具体的手术入路（trocar 位置）、手术方式等。结果 三维重建后的胰体尾部肿瘤与邻近脏器的三维结构清楚，特别 是肿瘤与脾动静脉以及脾门的关系明晰。所有患者均行腹腔镜下胰体尾切除，无围手术期死亡；在保脾方面，除1例因为是黏 液性囊腺癌而行胰体尾+脾切除外，其余5例均保留脾脏，保脾率为83.3%（5/6）；术后并发症方面，胰瘘发生率33.3%（2/6），无手 术后出血。平均住院天数12 d。结论 腹腔镜下胰体尾切除具有手术创伤小，术后恢复快、保脾率高等优点；胰腺CT 数据三维 重建对腹腔镜下胰体尾肿瘤切除的个体化手术方案制定有很大的应用价值。 关键词：胰腺囊性肿瘤；腹腔镜；数字医学；仿真手术 Application of three-dimensional visualization technology for laparoscopic resection of cystic carcinoma in the pancreatic body and tail HOU Baohua, CUI Peng, JIAN Zhixiang, LI Shaojie, CHEN Wei, OU Yingliang, OU Jinrui Department of General Surgery, Guangdong General Hospital//Guangdong Academy of Medical Sciences, Guangzhou 510080, China Abstract: Objective To study the application of three-dimensional visualization technology for laparoscopic resection of cystic carcinoma in the pancreatic body and tail. Methods Six cases of cystic carcinoma in the pancreatic body and tail treated between Nov, 2009 and Mar, 2011 were retrospectively analyzed. The original image data of 64-slice spiral CT were collected and using adaptive region growing algorithm, the serial CT images were segmented and automatically extracted to obtain the 3-dimensional reconstruction images with customized image manipulation software. The specific surgical approach (the trocar position) and surgical procedure were planned based on the reconstructed mode. Results The reconstructed 3-dimensional model clearly displayed cystic carcinoma in the pancreatic body a