Intraoperative liver ultrasound: the Chinese experience

This article introduces the experience in intraoperative liver ultrasound in China. Intraoperative liver ultrasound was mainly used in patients treated for hepatocellular carcinoma (HCC) and hepatolithiasis, with purposes for further diagnosis and decision making and guidance of surgical procedures. With respect to detection of liver tumors, intraoperative ultrasound (IOUS) was significantly more sensitive, especially in small foci, as compared with preoperative ultrasound and computed tomography scanning, as well as intraoperative inspection and palpation. It was also more precise in localizing lesions than preoperative imaging investigations. Intraoperative echoangiography via hepatic arterial injection of carbon dioxide was shown not only to help assess position of catheter and vascularity of tumors but also to improve sensitivity in detecting small tumor foci in patients undergoing hepatic arterial chemoembolization. Intraoperative ultrasound was also used to guide hepatectomies. It ensured to obtain curative resection of the tumors and maximum preservation of functioning hepatic parenchyma simultaneously. For hepatolithiasis, IOUS offered accurate localization of stones, lithotomy (with its guidance), reduction of the rate of residual stones, and follow-up of the outcome of lithotomy.