Review articleIntraoperative ultrasonography in liver cancer
Section snippets
Technical aspects
IOUS uses flat, high-frequency echoprobes (7.5–10 MHz), which can be manipulated in deep and narrow spaces. T-shaped probes, interdigital probes, and microconvex probes are available for this purpose. Surgeons performing IOUS must have a perfect knowledge of liver anatomy as seen surgically and ultrasonographically. For surgical anatomy, the Couinaud segments are here considered [6]. After the abdominal cavity is entered, the liver must be mobilized by division of the round and falciform
Indications
The indications for IOUS in liver resection include complete exploration of the liver to determine the extent of disease, guidance of liver-directed therapy procedures, and margin control in the management of tumors involving the hepatic veins.
Summary
IOUS has become increasingly important for surgical resection in patients with cirrhosis and healthy liver. IOUS is important in the diagnosis and staging of liver cancer and as an element of the surgical technique, and IOUS can now be considered a fundamental tool for hepatobiliary and other surgical procedures [3]. The American College of Surgeons has recently recognized the need for surgeons to have specific training in ultrasonography. Meanwhile, dedicated monographs on IOUS have been
References (42)
- et al.
History of intraoperative ultrasonography
Ultrasound Med Biol
(1998) - et al.
Management of new hepatic nodules detected by intraoperative ultrasonography during hepatic resection for hepatocellular carcinoma
Surgery
(1996) - et al.
New lesions detected by intraoperative ultrasound during liver resection for hepatocellular carcinoma
Ultrasound Med Biol
(2001) - et al.
A new technical aspect of ultrasound-guided liver surgery
Am J Surg
(1999) - et al.
Ultrasound-guided liver subsegmentectomy: the peculiarity of segment 4
J Am Coll Surg
(2001) - et al.
Treatment of irresectable liver tumors by percutaneous cryosurgery
Br J Surg
(1998) - et al.
Hepatocellular carcinoma and cirrhosis in 746 patients: long-term results of percutaneous ethanol injection
Radiology
(1995) - et al.
Ultrasonically guided liver surgery
Jpn J Ultrason Med
(1980) - et al.
Percutaneous radiofrequency ablation of hepatic metastases from colorectal cancer in 117 patients
Radiology
(2001) Le foie, étude anatomiques et chirurgicales
(1957)
Occult hepatic metastases in colorectal carcinoma
Br J Surg
Accuracy of intraoperative ultrasonography in diagnosing liver metastasis from colorectal cancer: evaluation with postoperative follow-up results
World J Surg
The impact of intraoperative ultrasonography on surgery for liver neoplasms
J Ultrasound Med
Laparoscopy and laparoscopic ultrasonography avoid exploratory laparotomy in patients with hepatocellular carcinoma
Ann Surg
Selection criteria for hepatectomy in patients with hepatocellular carcinoma and portal vein tumor thrombus
Ann Surg
The value of ultrasonography for hepatic surgery
Hepatogastroenterology
Intraoperative ultrasonic examination for hepatectomy
Jpn J Oncol
Utrasonically guided systematic subsegmentectomy
Surg Gynecol Obstet
A new method for mapping hepatic subsegment: counterstaining identification technique
Surgery
A new technique of hepatectomy using peroperative echography and intraparenchymatous guide needles. The geometer technique
J Chir
Hepatic resection guided by needles inserted under ultrasonographic guidance
Surgery
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