J.Jpn. Surg. Soc.. 82(9): 1099-1103, 1981

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Report on the annual meeting

THE SIGNIFICANCE OF INTRAOPERATIVE ULTRASONIC EXAMINATION FOR ABDOMINAL SURGERY

Intraoperative hepatic ultrasonography was performed on 46 patients with hepatic disease or with the disease of bile duct. Intraoperative pancreatic ultrasonography was performed on 16 patients with pancreatic disease. The purpose of the intraoperative hepatic ultrasonography was to make a perecise diagnois for 20 patients who were suspected to have hepatic tumor or hepatolithiasis preoperatively. The intraoperative hepatic ultrasonography aimed at bing a gude for the decision of the resectin line of the liver among 26 hepatectomized patiens. Ultrasonically guided typical hepatectomy was performed on 14 paients and atypical hepatctomy was performed on 12 patiens under ultrasonic control. Finding the location of hepatic vein with the intraoperative ultrasonic guide, rational, accurate hepatic segmentectomy could be performed along with hepatic vein on patients who had undergone typical hepatectomy. The intraoperative ultrasonogrpphy was of great value to find out the location of the utmor in th middle of the liver which was not palpable from the liver surface, and to confirm its relation to hepatic vein and portal system among the patients who had undergone atypical hepatectomy. Using intraoperative ultrasonography, atypical hepatectomy could be performed safely for the small sized hepatocellular carcinoma in cirrhotic liver and for metastatic hepatic tumor, because only minimal part of the liver could be resected with ultrasonic guide.
There were 10 cases of pancreatic cancer, 4 cases of of chronic pancreatitis and 2 cases of insulinoma among the patients of whom intraoprative pancreatic ultrasonography was performed. The ultrasonography was especially useful to find out the pancreative duct so that pancreaticojejunostomy could be performed for chronic pancreatitis without difficulties. The intraopertive pancreatic ultrasonography was also useful to find out the location of insulinoma.
We have devised and have employed a probe of ultrasonography of real time system, which has a hole in its center to pass the biopsy needle. We found that the probe was very convenient for intraoperative use. Since the probe is flat, whole liver can be scanned through an upper mid-abdominal incision. Furthermore the aimed lesion can be biopsied easily with the probe. The intraoperative ultrasonography is of great value in extending of the operative indication and for the improvement of the operative procedure. We believe that the intraoperative ultrasonography should be widely applied for many purposes.

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