Intraoperative ultrasonic examination for hepatectomy.

Area of Science:

• Hepatobiliary Surgery
• Surgical Oncology
• Medical Imaging

Background:

• Hepatectomy requires precise identification of liver lesions.
• Standard palpation and visual inspection may miss deep or small liver tumors.
• Accurate intraoperative assessment is crucial for successful liver resections.

Purpose of the Study:

• To evaluate the efficacy of intraoperative ultrasonic examination (IUE) in hepatectomy.
• To assess the detection rate of liver lesions and tumor thrombi using IUE.
• To determine the role of IUE in guiding partial hepatectomy.

Main Methods:

• Intraoperative ultrasonic examination (IUE) was conducted on 118 patients undergoing hepatectomy.
• Five types of real-time linear array transducers were utilized.
• Lesion detection, tumor thrombi identification, and surgical guidance were analyzed.

Main Results:

• IUE detected previously invisible or nonpalpable liver lesions in 58% of patients.
• Among 16 tumors, IUE identified 11 tumor thrombi (69%), surpassing angiography.
• IUE facilitated systematic subsegmentectomy and the novel concept of partial hepatectomy.

Conclusions:

• Intraoperative ultrasonic examination (IUE) is highly effective in detecting occult liver lesions during hepatectomy.
• IUE significantly improves the diagnosis of tumor thrombi compared to angiography.
• IUE is an indispensable tool for precise liver resections and partial hepatectomy.