Koo TH, Leong XB, Lee YL, Hayati F, Zakaria MH, Zakaria AD. Revolutionizing hepatolithiasis management: Transformative role of DynaCT in imaging and intervention. World J Gastrointest Surg 2025; 17(7): 103492 [DOI: 10.4240/wjgs.v17.i7.103492]
Corresponding Author of This Article
Andee Dzulkarnaen Zakaria, MD, Professor, Department of Surgery, School of Medical Sciences, Hospital Pakar Universiti Sains Malaysia, Jalan Raja Perempuan Zainab 2, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia. andee@usm.my
Research Domain of This Article
Surgery
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Thai-Hau Koo, Department of Internal Medicine, School of Medical Sciences, Hospital Universiti Sains Malaysia, Kota Bharu 16150, Kelantan, Malaysia
Xue-Bin Leong, Yi-Lin Lee, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia
Firdaus Hayati, Department of Surgery, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Sabah, Malaysia
Mohd Hazeman Zakaria, Department of Radiology, Faculty of Medicine and Health Science, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
Andee Dzulkarnaen Zakaria, Department of Surgery, School of Medical Sciences, Hospital Pakar Universiti Sains Malaysia, Kota Bharu 16150, Kelantan, Malaysia
Author contributions: Koo TH, Hayati F, and Zakaria AD designed the overall concept and outline of the manuscript; Leong XB, Lee YL, and Zakaria MH contributed to the discussion and design of the manuscript; Koo TH, Leong XB, Lee YL, Zakaria MH, and Zakaria AD contributed to the writing, and editing the manuscript, illustrations, and review of literature; and all authors have read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Andee Dzulkarnaen Zakaria, MD, Professor, Department of Surgery, School of Medical Sciences, Hospital Pakar Universiti Sains Malaysia, Jalan Raja Perempuan Zainab 2, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia. andee@usm.my
Received: November 22, 2024 Revised: March 8, 2025 Accepted: March 25, 2025 Published online: July 27, 2025 Processing time: 243 Days and 20.1 Hours
Abstract
In this editorial, we comment on the article by Ye et al. We specifically focused on the novel use of DynaCT biliary soft tissue reconstruction technology in the diagnosis and treatment of hepatolithiasis with bile duct stenosis, which is an innovative approach for enhancing the preoperative evaluation and surgical outcomes in hepatolithiasis. This study also highlights the limitations of conventional imaging techniques such as computed tomography and magnetic resonance cholangiopancreatography, which have low sensitivity for small stones and complex biliary strictures. Given the intricate anatomy of the biliary system and the challenges posed by limited visualization using conventional methods, DynaCT addresses these issues by providing high-resolution, three-dimensional reconstruction of the bile ducts, stones, and vascular structures, thus improving anatomical clarity and enabling precise surgical planning. We also focused specifically on the limitations of DynaCT, such as the need for specialized equipment and patient selection criteria, as well as its advantages and disadvantages compared with conventional PTOBF approaches. Overall, DynaCT represents a significant advancement in hepatolithiasis management, with the potential to become a standard imaging modality for safer and more effective biliary procedures.
Core Tip: DynaCT has revolutionized hepatolithiasis management by offering superior imaging and procedural precisions. This cutting-edge technology enhances the visualization of complex biliary and vascular anatomy, enabling accurate lesion detection and targeted interventions, particularly in combination with therapies such as transarterial chemoembolization and microwave ablation. Compared with traditional imaging, DynaCT demonstrates greater sensitivity and safety while minimizing complications. Despite challenges, such as high costs and training demands, its potential to optimize outcomes in hepatobiliary and other interventional fields is undeniable. This editorial underscores DynaCT’s transformative impact and explores future directions to maximize its clinical utility.