Role of intraoperative ultrasound of the liver with improved preoperative hepatic imaging.

Abstract

To find out whether intraoperative ultrasound (IOUS) of the liver should still be considered a routine procedure for patients having hepatic resections as their preoperative investigation has become so much better with the standard use of triphasic spiral computed tomograms (CT). Retrospective study. University medical centre, Utrecht, The Netherlands. 26 consecutive patients undergoing liver resection. How much additional information was given by IOUS, and its influence on operative strategy; how IOUS facilitated the hepatic resection. IOUS revealed additional information over triphasic CT in 13/26 patients, which led to a change in the surgical procedure in 4 (15%). For all 4 patients the change in surgical approach proved to be correct as judged by histology and clinical outcome. In 12 patients IOUS facilitated the resection by providing helpful three-dimensional anatomical insight. Despite recent improvements in preoperative investigation, IOUS should still be recommended as a routine procedure in patients having hepatic resections. In addition to aiding the ultimate decision about which part to resect, it also gives insight into the hepatic anatomy.