Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Aug 27;15(8):1693-1702.
doi: 10.4240/wjgs.v15.i8.1693.

Accurate resection of hilar cholangiocarcinoma using eOrganmap 3D reconstruction and full quantization technique

Da-Peng Cui  1 , Shuang Fan  1 , Ying-Xue Guo  1 , Qian-Wei Zhao  1 , Yue-Xin Qiao  1 , Jian-Dong Fei  2
Affiliations

Accurate resection of hilar cholangiocarcinoma using eOrganmap 3D reconstruction and full quantization technique

Da-Peng Cui et al. World J Gastrointest Surg. .

Abstract

Background: For treatment of hilar cholangiocarcinoma (HCCA), the rate of radical resection is low and prognosis is poor, and preoperative evaluation is not sufficiently accurate. 3D visualization has the advantage of giving a stereoscopic view, which makes accurate resection of HCCA possible.

Aim: To establish precise resection of HCCA based on eOrganmap 3D reconstruction and full quantification technology.

Methods: We retrospectively analyzed the clinical data of 73 patients who underwent HCCA surgery. All patients were assigned to two groups. The traditional group received traditional 2D imaging planning before surgery (n = 35). The eOrganmap group underwent 3D reconstruction and full quantitative technical planning before surgery (n = 38). The preoperative evaluation, anatomical classification of hilar hepatic vessels, indicators associated with surgery, postoperative complications, liver function, and stress response indexes were compared between the groups.

Results: Compared with the traditional group, the amount of intraoperative blood loss in the eOrganmap group was lower, the operating time and postoperative intestinal ventilation time were shorter, and R0 resection rate and lymph node dissection number were higher (P < 0.05). The total complication rate in the eOrganmap group was 21.05% compared with 25.71% in the traditional group (P > 0.05). The levels of total bilirubin, Albumin (ALB) , aspartate transaminase, and alanine transaminase in the eOrganmap group were significantly different from those in the traditional group (intergroup effect: F = 450.400, 79.120, 95.730, and 13.240, respectively; all P < 0.001). Total bilirubin, aspartate transaminase, and alanine transaminase in both groups showed a decreasing trend with time (time effect: F = 30.270, 17.340, and 13.380, respectively; all P < 0.001). There was an interaction between patient group and time (interaction effect: F = 3.072, 2.965, and 2.703, respectively; P = 0.0282, 0.032, and 0.046, respectively); ALB levels in both groups tended to increase with time (time effect: F = 22.490, P < 0.001), and there was an interaction effect between groups and time (interaction effect: F = 4.607, P = 0.004). In the eOrganmap group, there was a high correlation between the actual volume of intraoperative liver specimen resection and the volume of preoperative virtual liver resection (t = 0.916, P < 0.001).

Conclusion: The establishment of accurate laparoscopic resection of hilar cholangiocarcinoma based on preoperative eOrganmap 3D reconstruction and full quantization technology can make laparoscopic resection of hilar cholangiocarcinoma more accurate and safe.

Keywords: 3D reconstruction; Full quantification technology; Hilar cholangiocarcinoma; Laparoscopic surgery; Precise resection; eOrganmap.

PubMed Disclaimer

Conflict of interest statement

Conflict-of-interest statement: The authors declare no conflicts of interest for this article.

Figures

Figure 1
Figure 1
Study protocol.
Figure 2
Figure 2
Interleukin-6, cortisol and norepinephrine levels. There were 35 cases in the traditional group and 38 in the eOrganmap group. A: Interleukin-6 Levels; B: Cortisol levels; C: Norepinephrine levels. Notes: IL-6: Interleukin-6; Cor: Cortisol; NE: Norepinephrine.
See this image and copyright information in PMC

References

    1. Abou-Alfa GK, Macarulla T, Javle MM, Kelley RK, Lubner SJ, Adeva J, Cleary JM, Catenacci DV, Borad MJ, Bridgewater J, Harris WP, Murphy AG, Oh DY, Whisenant J, Lowery MA, Goyal L, Shroff RT, El-Khoueiry AB, Fan B, Wu B, Chamberlain CX, Jiang L, Gliser C, Pandya SS, Valle JW, Zhu AX. Ivosidenib in IDH1-mutant, chemotherapy-refractory cholangiocarcinoma (ClarIDHy): a multicentre, randomised, double-blind, placebo-controlled, phase 3 study. Lancet Oncol. 2020;21:796–807. - PMC - PubMed
    1. Li H, Zhang ZY, Zhou ZQ, Guan J, Tong DN, Zhou GW. Combined gemcitabine and S-1 chemotherapy for treating unresectable hilar cholangiocarcinoma: a randomized open-label clinical trial. Oncotarget. 2016;7:26888–26897. - PMC - PubMed
    1. Ma D, Wang W, Wang J, Zhang T, Jiang Z, Du G, Yang J, Zhang X, Qin G, Jin B. Laparoscopic versus open surgery for hilar cholangiocarcinoma: a retrospective cohort study on short-term and long-term outcomes. Surg Endosc. 2022;36:3721–3731. - PubMed
    1. Matsuo K, Rocha FG, Ito K, D'Angelica MI, Allen PJ, Fong Y, Dematteo RP, Gonen M, Endo I, Jarnagin WR. The Blumgart preoperative staging system for hilar cholangiocarcinoma: analysis of resectability and outcomes in 380 patients. J Am Coll Surg. 2012;215:343–355. - PubMed
    1. Peng Y, Zhao Z, Zhao Y, Wang Z, Li J, Zhang H, Liu X, Zhou X. Three-dimensional reconstruction of magnetic resonance images of carp brain for brain control technology. J Neurosci Methods. 2022;366:109428. - PubMed