[The intraoperative echography of malignant hepatic lesions]

IOU (intraoperative ultrasound) is nowadays an indispensable technique for the surgeon to confirm the information collected from preoperative tests or to gain further information that may modify surgical strategy. A series of 350 patients were studied with IOU: in 67 cases the liver was involved, with 23 malignant lesions. In the latter group, 10 lesions were found which had been missed even at palpation; the size of 9 of them could be correctly assessed, which had been overestimated in 8 cases and underestimated in 1 before surgery. Moreover, in 39.1% of the cases, the information yielded by IOU determined a change in surgical strategy, favoring a more accurate dissection of the lesion. Surgery was modified depending on the recognition of: nonpalpable lesions (5 cases); portal thrombosis (1 case); lesions bigger (2 cases)--smaller (2 cases) than preoperatively diagnosed. Moreover, IOU was a useful tool to guide the surgeon during intervention, by yielding accurate anatomical information on the segment/segments hosting the lesion.