A retrospective cohort study on the protective role of 3D-Printed CT/MRI-based models in preventing vascular injury during hepatectomy

To evaluate the protective effect of 3D printed models based on radiological imaging (CT/MRI) on vascular injury during hepatectomy and their impact on postoperative liver function recovery. A retrospective analysis was conducted on 242 patients who underwent open hepatectomy for primary hepatocellular carcinoma (HCC) from June 2019 to May 2023. Patients were divided into a conventional group (n = 129) and a 3D group (n = 113). The conventional group relied solely on two-dimensional CT/MRI images for surgical planning, while the 3D group utilized additional 3D printed models derived from radiological data. Observation indicators included operative time, intraoperative blood loss, duration of hepatic pedicle clamping, hospital stay, liver tissue volume, liver function markers, complications, and prognostic outcomes. The 3D group showed shorter operative times (181.35 ± 44.58 min vs 197.48 ± 51.24 min) and reduced intraoperative blood loss (283.47 ± 34.52 mL vs 297.83 ± 47.58 mL) compared to the conventional group. Future liver remnant (FLR) volumes were higher in the 3D group, indicating better preservation of functional liver tissue. Postoperative liver function indicators such as ALT, AST, TBIL, γ-GT, and PT levels improved more rapidly in the 3D group. Univariate and multivariate logistic regression analyses identified the use of 3D printing models as a significant protective factor against vascular injury and poor liver function recovery (all P < 0.05). The use of 3D-printed CT/MRI-based models improved surgical efficiency and early postoperative liver function recovery, although long-term outcomes require further confirmation. These models may provide detailed anatomical insights that aid in precise surgical planning and execution, thereby reducing the risk of vascular injury and promoting faster liver regeneration.