Retrospective Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 7, 2018; 24(17): 1911-1918
Published online May 7, 2018. doi: 10.3748/wjg.v24.i17.1911
Usefulness of three-dimensional visualization technology in minimally invasive treatment for infected necrotizing pancreatitis
Peng-Fei Wang, Zhi-Wei Liu, Shou-Wang Cai, Jun-Jun Su, Lei He, Jian Feng, Xian-Lei Xin, Shi-Chun Lu
Peng-Fei Wang, Zhi-Wei Liu, Shou-Wang Cai, Jun-Jun Su, Lei He, Jian Feng, Xian-Lei Xin, Shi-Chun Lu, Department of Hepatobiliary Surgery, PLA General Hospital, Beijing 100853, China
Author contributions: Wang PF, Liu ZW and Cai SW carried out the studies, participated in collecting the data, and drafted the manuscript; He L and Feng J performed the statistical analysis and participated in its design; Su JJ, Xin XL and Lu SC helped to draft the manuscript; all authors read and approved the final manuscript.
Supported by Beijing Natural Science Foundation, No. 7172201.
Institutional review board statement: This study was approved by the ethics committee of the PLA General Hospital (20170078).
Informed consent statement: All participants provided written informed consent.
Conflict-of-interest statement: All authors declare no conflicts-of-interest related to this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Shou-Wang Cai, MD, PhD, Chief Doctor, Department of Hepatobiliary Surgery, PLA General Hospital, Beijing 100853, China. caisw8077.cai@vip.sina.com
Telephone: +86-10-66938130 Fax: +86-21-57643271
Received: March 7, 2018
Peer-review started: March 7, 2018
First decision: March 21, 2018
Revised: April 2, 2018
Accepted: April 9, 2018
Article in press: April 9, 2018
Published online: May 7, 2018
Abstract
AIM

To explore the value of three-dimensional (3D) visualization technology in the minimally invasive treatment for infected necrotizing pancreatitis (INP).

METHODS

Clinical data of 18 patients with INP, who were admitted to the PLA General Hospital in 2017, were retrospectively analyzed. Two-dimensional images of computed tomography were converted into 3D images based on 3D visualization technology. The size, number, shape and position of lesions and their relationship with major abdominal vasculature were well displayed. Also, percutaneous catheter drainage (PCD) number and puncture paths were designed through virtual surgery (percutaneous nephroscopic necrosectomy) based on the principle of maximum removal of infected necrosis conveniently.

RESULTS

Abdominal 3D visualization images of all the patients were well reconstructed, and the optimal PCD puncture paths were well designed. Infected necrosis was conveniently removed in abundance using a nephroscope during the following surgery, and the median operation time was 102 (102 ± 20.7) min. Only 1 patient underwent endoscopic necrosectomy because of residual necrosis.

CONCLUSION

The 3D visualization technology could optimize the PCD puncture paths, improving the drainage effect in patients with INP. Moreover, it significantly increased the efficiency of necrosectomy through the rigid nephroscope. As a result, it decreased operation times and improved the prognosis.

Keywords: Infected necrotizing pancreatitis, Three-dimensional visualization, Percutaneous catheter drainage, Percutaneous nephroscopic necrosectomy

Core tip: As a lethal disease, infected necrotizing pancreatitis is gradually treated by minimally invasive surgery. Percutaneous catheter drainage (PCD) is the prerequisite of various minimally invasive treatment, which has been of great significance for prognosis of the disease. In this study, three-dimensional (3D) visualization technology was used preoperatively to optimize the puncture position and direction of PCD path. As a result, it improved the drainage effect and increased the efficiency of subsequent necrosectomy. So, the 3D visualization technology was great help for the prognosis of infected necrotizing pancreatitis.