摘要目的 探讨三维可视化(Three-dimensional Visualization)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,导入三维重建可视化软件-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入路,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.

abstractsObjective To evaluate the clinical effect of three-dimensional visualization technology in middle pancreatectomy (MP). Methods The original image data of 64-slices piral CT were obtained from 3 patients with tumor in the neck or body of the pancreas. Data were impoted in the medical image proceeding system (MIPS) which was designed by us. Then pancrea, pancreatic tumor, vascular system and other organs around the pancrease were three-dimensionally reconstructed. By observing the spatial anatomical relationship between tumor and surrounding organs or blood vessels, surgical approach was designed to guide operation. Results Using MIPS, the pancreas, tumos, surrounding organs and blood vessels in 3 patients were three-dimensionally reconstructed successfully, and these 3D pictures could clearly show the spatial anatomy of tumor and surrounding organs by visualization techniques. According to the results of three-dimensional reconstruction, two patients were performed middle pancreatectomy successfully with open operation, and one patient was performed laparoscopic middle pancreatectomy successfully. No postoperative complications such as bleeding, pancreatic leakage or diabetes were observed. Conclusion Three-dimensional reconstruction and visualization technology have great potential values for designing individualized pancreatic surgery, and it can further expand to application for other abdominal surgery.