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
ARTICLE HIGHLIGHTS
Research background

Infected necrotizing pancreatitis (INP) is a severe disease with high mortality, which generally requires percutaneous catheter drainage (PCD) and following surgical debridement if necessary. Whether the puncture paths of PCD are appropriate or not is related to not only the effect of drainage but also the efficiency of subsequent minimally invasive removal of infected necrosis. However, a number of patients’ PCDs were insufficient or even the catheter passed through the hollow organs due to the doctors’ lack of experience, which was a disaster for INP patients.

Research motivation

Three-dimensional (3D) visualization technology has been proved to be of great help for precise intervention or surgery, which also might be useful to optimize the puncture paths of multiple PCDs for INP patients.

Research objectives

To explore the value of 3D visualization technology for PCDs in INP patients.

Research methods

Preoperative computed tomography images were converted into 3D modellings through a software and the lesions were well displayed. PCD number and puncture paths were designed through virtual surgery (percutaneous nephroscopic necrosectomy) based on the principle of maximum removal of infected necrosis conveniently. We retrospectively analyzed 18 INP patients’ clinical data and present a typical case in detail.

Research results

All the patients’ 3D modellings was well reconstructed, through which the optimal PCD paths were designed. As a result, infected necrosis was conveniently removed in abundance using a nephroscope during the following surgery and two-thirds of the patients were cured after only one-time operation. Postoperative hospitalization time was 35 d on average, no major surgical complications occurred, and no one died.

Research conclusions

3D visualization technology was useful for INP patients to maximize the PCD effect. Moreover, it significantly improved the efficiency of subsequent percutaneous nephroscopic necrosectomy, which was critically important for improving the prognosis.

Research perspectives

Although the case number of this study was limited, the initial result indicated the value of 3D visualization technology for this terrible disease. Of course, analysis of more cases from multiple centers is needed to support the findings.