Clinical relevance of preoperative CT- based computer aided 3D- planning in hepatobiliary, pancreatic surgery and living donor liver transplantation

Multiple imaging approaches are currently used for diagnosis and surgery planning of hepatobiliary tumors and living donor liver transplantations. Conventional imaging studies remain insufficient to demonstrate the individual anatomy. Refinements in CT technology with the introduction of "multidetector-row" CT scanners and implementation of mathematical methods on computerized digital data enabled CT based 3D- visualizations. This renders preoperative surgery planning more reliable and reproducible. Since the application in oncological liver surgery has been studied previously, our interest focussed on pancreatic- and biliary tract tumors including preoperative work-up in living donor liver transplantation. A total of 29 patients were assessed. CT based 3D- display provided accurate preoperative visualization and computerized risk analyses for safety margins of pancreatic- and biliary- tract tumors. In living related liver transplantation the 3D- procedure may help to r ecognize vascular variants and to define the splitting line. The results may have major impact on patient selection and in our opinion allow better planning of the appropriate surgical approach.