ObjectivesTo systematically review the clinical efficacy of three-dimensional (3D) visualization vs. two-dimensional (2D) imaging technique in hepatectomy.MethodsPubMed, EMbase, The Cochrane Library, CBM, CNKI, WanFang Data and VIP databases were electronically searched to collect clinical trials which compared 3D visualization with conventional 2D imaging technique for hepatectomy from inception to September 2017. Two reviewers independently screened literature, extracted data and assessed the risk bias of included studies, and then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 11 studies involving 953 patients were included. The results of meta-analysis showed that: compared to 2D imaging technique, 3D visualization technique could improve R0 resection rate (OR=2.91, 95%CI 1.31 to 6.43, P=0.009), had lower incidence of postoperative complication (OR=0.55, 95%CI 0.38 to 0.80, P=0.002), less amount of blood transfusion in operation (MD=–96.05, 95%CI –126.78 to –65.31, P<0.000 01), lower discrepancy range between the volume of the predicted liver resection and actual resection volume (MD=–94.38, 95%CI –185.46 to –3.30,P=0.04), shorter operation time (MD=–33.58, 95%CI –60.09 to –7.08, P=0.01), and lower intraoperative blood loss (MD=–79.70, 95%CI –139.86 to –19.53, P=0.009), the differences were statistically significant. There were no statistical differences between two groups in postoperative hospital stay time (MD=–0.75, 95%CI –2.45 to 0.95, P=0.39).ConclusionsThe current evidence shows that application of 3D visualization technique in hepatectomy can predict the liver resection volume more accurately, improve the R0 resection rate, shorten operation time, decrease intraoperative blood transfusion volume and the amount of bleeding, and reduce the incidence of postoperative complications. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify above conclusion.
目的比较腹腔镜胆囊切除联合胆总管探查术（LC＋LCBDE）与内镜下Oddi括约肌切开取石联合腹腔镜胆囊切除术（EST＋LC）治疗胆囊结石合并肝外胆管结石的临床疗效。 方法回顾性分析45例行LC＋LCBDE及60例行EST＋LC患者的临床资料，观察2组在单次结石清除率、中转手术率、手术并发症、住院时间等指标方面的效果。 结果2组患者的基线资料相近，无手术死亡病例；2组术后并发症发生情况的差异无统计学意义（P＞0.05）；LC＋LCBDE组单次治疗成功率高于EST＋LC组，而住院时间及中转手术率则短于或低于EST＋LC组（P＜0.05）。 结论LC＋LCBDE是治疗胆囊结石合并肝外胆管结石患者安全有效的方法。