Aims and objectives
Intraoperative ultrasound (IOUS) has been an important imaging tool for guiding hepatic surgery since its inception in the early 1980s [1-3].
it has long been considered as the most sensitive and reliable technique for detecting and localizing hepatic lesions as well as their association with major vascular structures [4,5].
But with modern progresses in preoperative cross-sectional imaging of the liver,
especially with the inception of multislice computed tomography and diffusion weighted imaging in MRI [6-9],
its role has become controversed [10-13].
Methods and materials
In this prospective study,
24 patients having undergone 25 hepatic resections between September 2016 and September 2017 were included : 11 men and 13 women.
Their ages ranged from 36 to 78,
with a mean age of 56 years.
There were 9 patients with liver metastases,
9 patients with hydatid cysts,
3 patients with cholangiocarcinomas,
3 patients with bile duct injuries and one patient with a hepatocellular carcinoma (HCC).
All IOUS and surgeries were performed at the general surgery department of Mahmoud Matri Hospital...
Preoperative imaging identified 20 liver metastases in 9 patients ,15 hydatid cysts in 9 patients ,3 choloangiocarcinomas ,3 bile duct injuries and one hepatocellular carcinoma.
The medium delay between the last preoperative imaging and the operation was 11 days.
Compared with preoperative imaging,
three additional liver metastases (15%) were detected in two patients intraoperatively.
One of these metastases was superficial and could only be detected by inspection.
The two others were detected by IOUS.
IOUS also detected a nodule associated with HCC in...
Due to its high spatial resolution and by offering a real-time imaging,
IOUS continues to be a valuable tool during hepatic surgery.
Although its role in tumor detection has been reduced due to recent advances in preoperative imaging techniques,
IOUS still provides additional information for tumor restaging and determining resectability.
In this series it altered surgical plan in 40%ofthecases and facilitated the hepatic resection for the surgeon in allpatients.
Faculty of medicine of Tunis,
Mahmoud Matri Hospital,
Phone: +216 98 36 91 60
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