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Updated: Mar 24, 2026
Three-dimensional Location Approach with Silk Thread Guided Laparoscopic Segmentectomy for Liver Tumor
Published on: May 23, 2025
3D-guided planning enhances safety of laparoscopic resection for special liver segments: A propensity score-matched
Jiahao Chen1, Hanlin Jiang1, Boen Xiao1
1Department of Hepatobiliary Surgery, The Affiliated Suzhou Hospital of Nanjing Medical University, Gusu School, Nanjing Medical University, Suzhou, 215000, China.
Background:
Laparoscopic hepatectomy (LH) for tumors in complex segments (Couinaud I, IVa, VII, VIII) is technically challenging. This study evaluates an integrated 3D-guided planning system combining preoperative 3D reconstruction with intraoperative ultrasonography and 3D laparoscopy.
Methods:
In this retrospective study of 217 patients undergoing LH, outcomes were compared between a 3D-guided planning group (n = 105) and a routine group (n = 112) using 1:1 propensity score matching (PSM).
Results:
After PSM (65 pairs), the 3D group had significantly reduced intraoperative blood loss (80 vs. 160 mL, P < 0.001) and bile leakage rate (3.1% vs. 15.4%, P = 0.015). In the special-segment subgroup, the 3D group also demonstrated shorter operative time (180 vs. 250 min, P < 0.001) and lower bile leakage (9.5% vs. 42.9%, P = 0.014).
Conclusion:
The integrated 3D-guided planning system substantially reduces intraoperative blood loss during LH, especially for tumors located in the special segments designated by the Louisville Statement.
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