• Rui Tang, Longfei Ma, Canhong Xiang, Xuedong Wang, Ang Li, Hongen Liao, and Jiahong Dong.
• aDepartment of Hepatopancreatobiliary Surgery, Beijing Tsinghua Changgung Hospital bDepartment of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China.
• Medicine (Baltimore). 2017 Sep 1; 96 (37): e8083.

RationalePatients who undergo hilar cholangiocarcinoma (HCAC) resection with concomitant hepatectomy have a high risk of postoperative morbidity and mortality due to surgical trauma to the hepatic and biliary vasculature.Patient ConcernsA 58-year-old Chinese man with yellowing skin and sclera, abdominal distension, pruritus, and anorexia for approximately 3 weeks.DiagnosesMagnetic resonance cholangiopancreatography and enhanced computed tomography (CT) scanning revealed a mass over the biliary tree at the porta hepatis, which diagnosed to be s a hilar cholangiocarcinoma.InterventionThree-dimensional (3D) images of the patient's hepatic and biliary structures were reconstructed preoperatively from CT data, and the 3D images were used for preoperative planning and augmented reality (AR)-assisted intraoperative navigation during open HCAC resection with hemihepatectomy. A 3D-printed model of the patient's biliary structures was also used intraoperatively as a visual reference.OutcomesNo serious postoperative complications occurred, and the patient was tumor-free at the 9-month follow-up examination based on CT results.LessonsAR-assisted preoperative planning and intraoperative navigation might be beneficial in other patients with HCAC patients to reduce postoperative complications and ensure disease-free survival. In our postoperative analysis, we also found that, when the3D images were superimposed 3D-printed model using a see-through integral video graphy display device, our senses of depth perception and motion parallax were improved, compared with that which we had experienced intraoperatively using the videobased AR display system.

20 keywords...

hide…