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Imagawa N, Fukasawa M, Takano S, Kawakami S, Fukasawa Y, Hasegawa H, Kuratomi N, Harai S, Shimamura N, Yoshimura D, Kobayashi S, Yoshida T, Sato M, Suzuki Y, Enomoto N. A Novel Method of Calculating the Drained Liver Volume Using a 3D Volume Analyzer for Biliary Drainage of Unresectable Malignant Hilar Biliary Obstruction. Dig Dis Sci 2024; 69:969-977. [PMID: 38300418 PMCID: PMC10960883 DOI: 10.1007/s10620-024-08294-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 01/10/2024] [Indexed: 02/02/2024]
Abstract
OBJECTIVES In patients with unresectable malignant hilar biliary obstruction (UMHBO), drainage of ≥ 50% liver volume correlates with better clinical outcomes. Accurately measuring the liver volume to be drained by biliary stents is required. We aimed to develop a novel method for calculating the drained liver volume (DLV) using a 3D volume analyzer (3D volumetry), and assess the usefulness for drainage in patients with UMHBO. METHODS Three-dimensional volumetry comprises the following steps: (1) manual tracing of bile duct using 3D imaging system; (2) 3D reconstruction of bile duct and liver parenchyma; and (3) calculating DLV according to the 3D distribution of bile ducts. Using 3D volumetry, we reviewed data of patients who underwent biliary drainage for UMHBO, calculated the DLV, and determined the association between DLV and biliary drainage outcome. RESULTS There were 104 eligible cases. The mean DLV was 708 ± 393 ml (53% ± 21%). and 65 patients (63%) underwent drainage of ≥50% liver volume. The clinical success rate was significantly higher in patients with DLV ≥ 50% than in patients with DLV < 50% (89% vs. 28%, P < 0.001). The median time to recurrence of biliary obstruction (TRBO) and survival time were significantly longer in patients with DLV ≥ 50% than in patients with DLV < 50% (TRBO, 292 vs. 119 days, P = 0.03; survival, 285 vs. 65days, P = 0.004, log-rank test, respectively). CONCLUSIONS Three-dimensional volumetry, a novel method to calculate DLV accurately according to bile duct distribution was useful for drainage in UMHBO patients.
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Affiliation(s)
- Naoto Imagawa
- Department of Gastroenterology, University of Yamanashi, Shimokato, Chuo City, 1110, 409-3898, Yamanashi, Japan
| | - Mitsuharu Fukasawa
- Department of Gastroenterology, University of Yamanashi, Shimokato, Chuo City, 1110, 409-3898, Yamanashi, Japan.
- Department of Gastroenterology, Japan Community Health care Organization Yamanashi Hospital, 3-11-16, Asahi, Kofu City, 400-0025, Yamanashi, Japan.
| | - Shinichi Takano
- Department of Gastroenterology, University of Yamanashi, Shimokato, Chuo City, 1110, 409-3898, Yamanashi, Japan
| | - Satoshi Kawakami
- Department of Gastroenterology, University of Yamanashi, Shimokato, Chuo City, 1110, 409-3898, Yamanashi, Japan
| | - Yoshimitsu Fukasawa
- Department of Gastroenterology, University of Yamanashi, Shimokato, Chuo City, 1110, 409-3898, Yamanashi, Japan
| | - Hiroyuki Hasegawa
- Department of Gastroenterology, University of Yamanashi, Shimokato, Chuo City, 1110, 409-3898, Yamanashi, Japan
- Department of Gastroenterology, Japan Community Health care Organization Yamanashi Hospital, 3-11-16, Asahi, Kofu City, 400-0025, Yamanashi, Japan
| | - Natsuhiko Kuratomi
- Department of Gastroenterology, University of Yamanashi, Shimokato, Chuo City, 1110, 409-3898, Yamanashi, Japan
| | - Shota Harai
- Department of Gastroenterology, University of Yamanashi, Shimokato, Chuo City, 1110, 409-3898, Yamanashi, Japan
| | - Naruki Shimamura
- Department of Gastroenterology, University of Yamanashi, Shimokato, Chuo City, 1110, 409-3898, Yamanashi, Japan
| | - Dai Yoshimura
- Department of Gastroenterology, University of Yamanashi, Shimokato, Chuo City, 1110, 409-3898, Yamanashi, Japan
| | - Shoji Kobayashi
- Department of Gastroenterology, University of Yamanashi, Shimokato, Chuo City, 1110, 409-3898, Yamanashi, Japan
| | - Takashi Yoshida
- Department of Gastroenterology, University of Yamanashi, Shimokato, Chuo City, 1110, 409-3898, Yamanashi, Japan
| | - Mitsuaki Sato
- Department of Gastroenterology, University of Yamanashi, Shimokato, Chuo City, 1110, 409-3898, Yamanashi, Japan
| | - Yuichiro Suzuki
- Department of Gastroenterology, University of Yamanashi, Shimokato, Chuo City, 1110, 409-3898, Yamanashi, Japan
| | - Nobuyuki Enomoto
- Department of Gastroenterology, University of Yamanashi, Shimokato, Chuo City, 1110, 409-3898, Yamanashi, Japan
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