Precise planning based on 3D-printed dry-laboratory models can reduce perioperative complications of laparoscopic surgery for complex hepatobiliary diseases: a preoperative cohort study
Wei-Feng Yao,
Xiao-Kun Huang,
Tian-Wei Fu,
Lei Jin,
Cheng-Fei Du,
Zhen-Yu Gao,
Kai-Di Wang,
Mu-Gen Dai,
Si-Yu Liu,
Jun-Wei Liu,
Cheng-Wu Zhang,
Lei Liang,
Dong-Sheng Huang
Affiliations
Wei-Feng Yao
Department of Clinical Medicine, Medical College of Soochow University
Xiao-Kun Huang
General Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Affiliated People’s Hospital, Zhejiang Provincial People’s Hospital, Hangzhou Medical College
Tian-Wei Fu
General Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Affiliated People’s Hospital, Zhejiang Provincial People’s Hospital, Hangzhou Medical College
Lei Jin
General Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Affiliated People’s Hospital, Zhejiang Provincial People’s Hospital, Hangzhou Medical College
Cheng-Fei Du
General Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Affiliated People’s Hospital, Zhejiang Provincial People’s Hospital, Hangzhou Medical College
Zhen-Yu Gao
General Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Affiliated People’s Hospital, Zhejiang Provincial People’s Hospital, Hangzhou Medical College
Kai-Di Wang
General Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Affiliated People’s Hospital, Zhejiang Provincial People’s Hospital, Hangzhou Medical College
Mu-Gen Dai
Department of Gastroenterology, The Fifth Affiliated Hospital of Wenzhou Medical University
Si-Yu Liu
Department of Laboratory Medicine, The Key Laboratory of Imaging Diagnosis and Minimally Invasive Interventional Research of Zhejiang Province, Zhejiang University Lishui Hospital
Jun-Wei Liu
General Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Affiliated People’s Hospital, Zhejiang Provincial People’s Hospital, Hangzhou Medical College
Cheng-Wu Zhang
General Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Affiliated People’s Hospital, Zhejiang Provincial People’s Hospital, Hangzhou Medical College
Lei Liang
Department of Clinical Medicine, Medical College of Soochow University
Dong-Sheng Huang
Department of Clinical Medicine, Medical College of Soochow University
Abstract Background & aims Complications after laparoscopic liver resection (LLR) are important factors affecting the prognosis of patients, especially for complex hepatobiliary diseases. The present study aimed to evaluate the value of a three-dimensional (3D) printed dry-laboratory model in the precise planning of LLR for complex hepatobiliary diseases. Methods Patients with complex hepatobiliary diseases who underwent LLR were preoperatively enrolled, and divided into two groups according to whether using a 3D-printed dry-laboratory model (3D vs. control group). Clinical variables were assessed and complications were graded by the Clavien-Dindo classification. The Comprehensive Complication Index (CCI) scores were calculated and compared for each patient. Multivariable analysis was performed to determine the risk factors of postoperative complications. Results Sixty-two patients with complex hepatobiliary diseases underwent the precise planning of LLR. Among them, thirty-one patients acquired the guidance of a 3D-printed dry-laboratory model, and others were only guided by traditional enhanced CT or MRI. The results showed no significant differences between the two groups in baseline characters. However, compared to the control group, the 3D group had a lower incidence of intraoperative blood loss, as well as postoperative 30-day and major complications, especially bile leakage (all P < 0.05). The median score on the CCI was 20.9 (range 8.7–51.8) in the control group and 8.7 (range 8.7–43.4) in the 3D group (mean difference, -12.2, P = 0.004). Multivariable analysis showed the 3D model was an independent protective factor in decreasing postoperative complications. Subgroup analysis also showed that a 3D model could decrease postoperative complications, especially for bile leakage in patients with intrahepatic cholelithiasis. Conclusion The 3D-printed models can help reduce postoperative complications. The 3D-printed models should be recommended for patients with complex hepatobiliary diseases undergoing precise planning LLR.