[Laparoscopic ultrasonography in laparoscopic hepatectomy: experience with 22 cases]

To assess the value of laparoscopic ultrasonography in laparoscopic hepatectomy.

Twenty-two patients with liver diseases underwent laparoscopic ultrasonography. A 10 mm 7.5/10 MHz linear, side viewing laparoscopic ultrasonography probe was used intra-operatively to examine the convergence of intrahepatic biliary ducts and blood vessels, confirm and correct the resection line, guide the laparoscopic resection, examine the tumor margin, and discover the residue of calculi.

One additional tumor was detected in one primary liver tumor case during the laparoscopic hepatectomy. Laparoscopic hepatectomy was accomplished successfully in 21 patients one of which had to be transferred to laparotomy due to severe liver cirrhosis and uncontrollable bleeding. The average operation time was 157 min with the average examining and guiding time of 14 min. The intra-operative bleeding amount was 520 ml. No calculus and tumor residue were found. One case of post-operative liver wound bile leakage and one case of subphrenic hydrops were found and they both recovered after drainage.

Intra-operative laparoscopic ultrasonography helps evaluate the entire liver and decide the resection line accurately. Under its guiding the laparoscopic hepatectomy can be performed smoothly.