Journal of Clinical Hepatology
This study focuses on the three-dimensional reconstruction of the hepatic pedicle based on the Laennec membrane and its application in precise liver resection. Innovatively integrating enhanced CT imaging with 3D U-Net deep learning algorithms, it has achieved sub-millimeter-level (average error <0.5 mm) three-dimensional visualization of the Laennec membrane hepatic pedicle for the first time, systematically revealing four anatomical variations of the hepatic pedicle branches and establishing a morphological database containing length, diameter, and angle. In response to the problem that traditional total liver blood flow occlusion is prone to ischemia-reperfusion injury, the research team has developed a new type of hepatic pedicle sheath separation and occlusion clamp based on three-dimensional anatomical data, which can achieve regional selective blood flow occlusion during surgery. Clinical verification shows that the use of this device can significantly shorten the processing time and operation time of the hepatic pedicle, reduce intraoperative bleeding, and reduce the incidence of bile duct injury from 20% to 0. This technology promotes the transformation from "empirical surgery" to "individualized and precise surgery" and has important clinical promotion value.
This study has achieved the first three-dimensional reconstruction of the Laennec membrane hepatic pedicle based on CT imaging, breaking through the technical bottleneck of visualizing and identifying thin anatomical structures (thickness only 23.56~79.86 μm). By combining enhanced CT with 3D U-Net deep learning algorithms, it has achieved sub-millimeter-level precision segmentation (accuracy up to 96.8%), significantly improving the display ability of anatomical variations of the hepatic pedicle. The study systematically reveals four types of variations in the main branches of the hepatic pedicle and establishes a morphological database containing length, outer diameter, and angle, providing an objective basis for individualized precise liver resection. On this basis, the hepatic pedicle sheath separation and occlusion clamp has been developed, and clinical verification shows that it can significantly shorten the processing time and operation time of the hepatic pedicle, reduce the incidence of bile duct injury (0 vs 20%, P=0.031), and improve the safety and efficiency of surgery. This study has achieved the full chain clinical transformation from imaging anatomy to instrument innovation, promoting the development of standardized liver resection technology with the Laennec membrane as the anatomical landmark, and has important clinical promotion value.
Objective: To investigate the anatomical features of three-dimensional (3D) reconstruction of the hepatic pedicle based on the Laenne…
