Abstract: Objective To explore the clinical value of CT portal vein three-dimensional reconstruction in the surgery of hilarcholangiocarcinoma (HCCA). Methods Between August 2017 and August 2022, 68 HCCA patients were collected and underwent routine CT examination (N=38 cases) or 3D reconstruction of the portal vein (N=30 cases). The Bismuth Colette typing results, surgical conditions, and liver volume were compared between the routine CT and CT portal vein three-dimensional reconstruction. Results The diagnostic results of conventional CT preoperative imaging evaluation for type I HCCA are consistent, whereas the diagnostic results for type II, IIIa, IIIb, and IV HCCA are inconsistent with that of the postoperative pathological examination; The diagnostic results of pre-operative CT three-dimensional reconstruction imaging for types I, II, and IIIa were consistent, whereas the diagnostic results for types IIIb and IV were inconsistent with those of postoperative pathological examination. The intraoperative bleeding volume, surgical time, hospital stay, and postoperative extubation time of CT portal vein three-dimensional reconstruction were (524.3 ± 16.8) mL, (4.8 ± 1.2) h, (13.3 ± 2.0) d, and (9.6 ± 1.8) d, respectively, which were less/shorter than those of [(679.1 ± 17.3) mL, (6.3 ± 1.5) h, (16.4 ± 2.2) d, and (11.4 ± 1.9) d by conventional CT (All P<0.05). There was no statistically significant difference in the incidence of complications, liver resection volume, total liver volume, and percentage of remaining liver volume between the two groups (P>0.05). Conclusion The application of CT portal vein 3D reconstruction in the surgery of HCCA is not only conductive to evaluating Bismuth Colette classification, but also to reducing intraoperative bleeding and optimizing surgical indicators, which has certain clinical guidance significance.

Key words: CT three-dimensional reconstruction, Hilarcholangiocarcinoma, Surgical application