Value of 3D reconstructions in pancreatic surgery: Current status
Edouard Roussel, Jean Pinson, Lola Duhamel, Paul Martre, Gaetan Kerdelhué, Jean-Jacques Tuech, Lilian SchwarzJ Visc Surg. 2025 Oct 21:S1878-7886(25)00165-1. doi: 10.1016/j.jviscsurg.2025.09.011. Online ahead of print.
Abstract
Introduction: Three-dimensional (3D) reconstruction transforms cross-sectional medical images into interactive anatomical models, interpretable on an LCD screen, in augmented reality or via 3D printing. Although certain benefits have been established in liver surgery, its use in pancreatic surgery remains limited. This update outlines the applications of 3D visualization in pancreatic surgery, ranging from surgical planning to teaching.
Method: A systematic search for English-language articles reporting 3D pancreatic reconstructions in adult patients was conducted in PubMed, Web of Science, Lens.org and the Cochrane Library up to August 28, 2024. Of 1650 articles initially identified, 34 were retained after exclusion of duplicate publications and analysis of titles, abstracts and texts.
Results: The analysis of these studies suggests that 3D reconstruction, in comparison to cross-sectional imaging, could improve preoperative evaluation, by facilitating the detection of anatomical variations, the assessment of resection margins, and the prediction of morbidity and mortality according to tumor volume and residual pancreatic parenchyma. 3D imaging could also improve intraoperative safety, with some series reporting a 50% reduction of blood loss and a 25% reduction in operating time. 3D reconstruction is also a promising tool for teaching surgical anatomy, particularly through 3D printing.
Conclusion: 3D reconstruction could improve outcomes of pancreatic surgery but requires robust comparative studies before becoming a standard evidence-based practice.