J.Jpn. Surg. Soc.. 82(9): 1104-1108, 1981

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Report on the annual meeting

INTRA-OPERATIVE ULTRASONOGRAPHY FOR PANCREATIC SURGERY

Intra-operative ultrasonography with linear electronic real-time scanner was performed on 15 patients, 12 with pancreatic cancer, 2 with ampullary cancer and 1 with pancreatolithiasis. Water bath scan was further made on 11 resected specimens of the pancreas.
As the result, pancreatic cancer was presented as a relatively echo-poor area mostly with an irregular outline. The size of the tumors measured ultrasonically tended to be 0.5-2.0 cm smaller than the actual size of the tumors measured on the resected specimens.
Ultrasonographic portograms in pancreatic cancer were classified into the following three types; Type I (separate type) in which the portal vein keeps distant from the tumor echo, Type II (adjacent type) in which the portal vein is adjacent to the tumor echo but keeps its normal shape and Type III (fused type) in which the portal vein is fused with the tumor echo. Of 14 patients with pancreatic cancer or ampullary cancer, 4 belonged to Type I, 5 to Type II and 5 to Type III. Three of 4 type I cases showed no portal invasion, while all of the Type II and Type III cases showed macroscopic portal invasion. Superior mesenteric arterial invasion was also demonstrated well on the intra-operative ultrasonograms.
In a case with pancreatolithiasis, pancreatolithotomy was easily performed with the aid of the intraoperative ultrasound.

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