Application of a Three-Dimensional Reconstruction Technique in Liver Autotransplantation for End-Stage Hepatic Alveolar Echinococcosis

He, Yi-Biao; Bai, Lei; Jiang, Yi; Ji, Xuewu; Tai, Qin-wen; Zhao, Jinming; Zhang, Jinhui; Liu, Wenya; Wen, Hao

doi:10.1007/s11605-015-2842-z

Cited by 43 publications

(34 citation statements)

References 19 publications

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“…As the therapeutic approach for end-stage liver disease, liver transplantation tends to be mature and capable of providing the opportunities on late-stage hepatic alveolar echinococcosis. [ 19 ] However, the feasibility of liver transplantation is limited by its high cost, the shortage of donor organs, the demand of high surgical technique and the need for immunosuppression. [ 20 , 21 ] Moreover, liver autotransplantation which removed the entire diseased liver with replacement of the inferior vena cava by artificial blood vessels and then transplanted the remaining normal liver tissue itself with difficult anastomosis of hepatic artery and the portal vein, bring in troublesome technical issues.…”

Section: Discussionmentioning

confidence: 99%

The choose of different surgical therapies of hepatic alveolar echinococcosis

et al. 2018

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The aim of this study was to evaluate different surgical therapies for hepatic alveolar echinococcosis in different clinical stages.We analyze the clinical data of 115 patients who received surgical treatment in West China Hospital from January 2004 to June 2016. Among these patients, 77 cases underwent radical hepatic resection (group A, n = 77); 17 cases underwent palliative resection (group B, n = 17), and 21 cases underwent liver transplantation (group C, n = 21) with 12 cases of orthotopic liver transplantation and 9 cases of liver autotransplantation.The postoperative complication rate of radical hepatic resection group was 13.0% (10/77), which is statistically significant (P < .05) than the rate of palliative resection group 29.4% (5/17) or liver transplantation group 23.8% (5/21). The follow-up period ranged from 1 to 72 months. The overall median survival rate of radical resection was 72/77, higher than the rate of palliative group (12/17) or transplantation group (17/21), which was also statistically significant (P < .01).In our study, we believe in that all stages of hepatic alveolar echinococcosis should take active surgical interventions, and radical hepatic resection should be considered as the first-choice treatment for early stage of alveolar echinococcosis, while palliative surgery is still helpful to relieve symptoms and improve the life quality for advanced patients. Liver transplantation might also be an alternative option for the late-stage hepatic alveolar echinococcosis.

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Section: Discussionmentioning

confidence: 99%

The choose of different surgical therapies of hepatic alveolar echinococcosis

et al. 2018

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“…A 3‐dimensional (3D) imaging analysis system 19 calculated remnant liver volume (RLV) and visualized the vascular and biliary tract anatomy and the spatial location of the large masses (Figure 1B). The standard liver volume (SLV) was calculated following the experience of Urata et al20, 21 For patients with highly suspected extrahepatic metastases, positron emission tomography‐computed tomography (PET‐CT) was essential to determine whether there were any potential surgical contraindications.…”

Section: Methodsmentioning

confidence: 99%

Novel techniques and preliminary results of ex vivo liver resection and autotransplantation for end-stage hepatic alveolar echinococcosis: A study of 31 cases

Yang

Qiu

Huang

et al. 2018

American Journal of Transplantation

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Ex vivo liver resection combined with autotransplantation is a recently introduced approach to cure end‐stage hepatic alveolar echinococcosis (HAE), which is considered unresectable by conventional radical resection due to echinococcal dissemination into the crucial intrahepatic conduits and adjacent structures. This article aims discuss the manipulation details and propose reasonable indications for this promising technique. All patients successfully underwent liver autotransplantation with no intraoperative mortality. The median weight of the autografts was 636 g (360‐1300 g), the median operation time was 12.5 hours (9.4‐19.5 hours), and the median anhepatic phase was 309 minutes (180‐ 460 minutes). Intraoperative blood loss averaged 1800 mL (1200‐6000 mL). Postoperative complications occurred in 13 patients during hospitalization; 5 patients experienced postoperative complications classified as Clavien‐Dindo grade III or higher, and 2 patients died of intraabdominal bleeding and acute cerebral hemorrhage, respectively. Twenty‐nine patients were followed for a median of 14.0 months (3‐42 months), and no HAE recurrence was detected. The technique requires neither an organ donor nor any postoperative immunosuppressant, and the success of the treatment relies on meticulous preoperative assessments and precise surgical manipulation.

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“…Quantified 3D anatomic renderings of the liver and the lung inclusive of anatomic features (lesions, ducts, skin, bone, etc.) were then generated using the navigation system (Figures 2(a) – 2(d) ), [ 22 ]. Accuracy of the 3D anatomic map registration (i.e., image registration between the initial CT from which the 3D anatomic map was generated and the final needle tip position based on the coregistration of anatomic landmarks such as the carina or major vascular structures and fiducial markers placed on the skin) was determined using final needle tip position on the final conformational CT compared to the expected location of the needle tip based on the 3D model.…”

Section: Methodsmentioning

confidence: 99%

Application of Real-Time 3D Navigation System in CT-Guided Percutaneous Interventional Procedures: A Feasibility Study

Bhattacharji

Moore

2017

Radiology Research and Practice

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Introduction To evaluate the accuracy of a quantitative 3D navigation system for CT-guided interventional procedures in a two-part study. Materials and Methods Twenty-two procedures were performed in abdominal and thoracic phantoms. Accuracies of the 3D anatomy map registration and navigation were evaluated. Time used for the navigated procedures was recorded. In the IRB approved clinical evaluation, 21 patients scheduled for CT-guided thoracic and hepatic biopsy and ablations were recruited. CT-guided procedures were performed without following the 3D navigation display. Accuracy of navigation as well as workflow fitness of the system was evaluated. Results In phantoms, the average 3D anatomy map registration error was 1.79 mm. The average navigated needle placement accuracy for one-pass and two-pass procedures, respectively, was 2.0 ± 0.7 mm and 2.8 ± 1.1 mm in the liver and 2.7 ± 1.7 mm and 3.0 ± 1.4 mm in the lung. The average accuracy of the 3D navigation system in human subjects was 4.6 mm ± 3.1 for all procedures. The system fits the existing workflow of CT-guided interventions with minimum impact. Conclusion A 3D navigation system can be performed along the existing workflow and has the potential to navigate precision needle placement in CT-guided interventional procedures.

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Application of a Three-Dimensional Reconstruction Technique in Liver Autotransplantation for End-Stage Hepatic Alveolar Echinococcosis

Abstract: An individualized liver reconstruction technique can provide comprehensive anatomic information on livers of patients with end-stage HAE. Pre-operative virtual surgery can effectively improve the success rate of liver autotransplantation and reduce the risks of surgery.

Cited by 43 publications

References 19 publications

The choose of different surgical therapies of hepatic alveolar echinococcosis

The choose of different surgical therapies of hepatic alveolar echinococcosis

Novel techniques and preliminary results of ex vivo liver resection and autotransplantation for end-stage hepatic alveolar echinococcosis: A study of 31 cases

Application of Real-Time 3D Navigation System in CT-Guided Percutaneous Interventional Procedures: A Feasibility Study

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