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[Intraoperative ultrasonography of the liver].

INTRODUCTION
In many centers specialized in hepatobiliary surgery intraoperative sonography (IOUS) has become a mandatory intraoperative diagnostic tool for intraoperative decision making. We have started applying this technique during liver recections and operations for cancer of the colon in 1988. This presentation is a retrospective report on the first author's personal experience with this technique.


PATIENTS AND METHODS
Ninety-two patients were examined intraoperatively, either at Zürich University Hospital or Groote Schuur Hospital in Cape Town. There were 37 female and 55 male patients aged 21 to 84 years (average: 56 yrs). Thirteen patients had primary malignanctes of the liver (group 1) and37 patients underwent IOUS during liver resection for secondary liver tumors (group 2). 14 patients were scanned during operation for benign lesions of the bile ducts and liver (group 3). 28 patients were screened for metastases during resection of gastrointestinal cancers (group 4). The equipment consisted of an Aloka Echocamera SSD 630 and a T-shaped 5 MHz small part in Zürich and a Siemens SI 400 unit with a similar scanner in Cape Town.


RESULTS
In group 1 IOUS demonstrated additional information in 9 patients and changed operational procedure in 7 cases. In group 2 IOUS improved on preoperative imaging in 17 cases and changed the approach in 14. Seven patients with benign lesions profitted from IOUS. Additional information changing surgical procedure was gained by IOUS in 6 patients of group 4.


CONCLUSIONS
IOUS is a valuable intraoperative imaging technique which is easily performed by the surgeon himself. It should be part of every operation for cancer of the colon and every resection of the liver.