OBJECTIVETo assess the value of protective hepatectomy based on three-dimensional (3D) reconstruction technique in the treatment of hepatolithiasis.

METHODSThe image data of 64-slice spiral CT scan were obtained from 21 patients with hepatolithiasis and processed using the MI-3DVS software for 3D reconstruction and visible simulation surgery of protective hepatectomy. The actual protective hepatectomy for hepatolithiasis was performed based on the preoperative surgical plan according to the 3D model and the simulation hepatectomy. The consistency between the actual hepatectomy and the simulation surgery was evaluated, and the operating time, lengths of postoperative hospital stay, estimated blood loss, calculus depletion rate and intra- and postoperative complications were recorded.

RESULTSThe consistency rate between the actual procedures of hepatectomy were carried out with a total consistency with the preoperative surgical simulation, and the normal functioning liver tissues were retained in all the 21 patients. The operating time of the procedures was 215.2∓51.3 min, the average postoperative hospital stay was 10.7∓4.3 days, estimated blood loss was 301.4∓60.7 ml, and the calculus depletion rate was 95.2%. The procedure was associated with an incidence of intra- and postoperative complications of 19.0%.

CONCLUSIONProtective hepatectomy for hepatolithiasis based on 3D technique allows efficient calculus depletion, lesion removal, elimination of strictures, and total bile drainage, and also protects the maximum functional liver tissue and reduces the surgical complications.