Intraoperative hepatic ultrasonography--an indispensable procedure in resection of small hepatocellular carcinomas.

Hepatic ultrasonography (US) was performed during laparotomy in 47 patients with hepatocellular carcinomas (HCC) less than 5 cm in size. It detected more tumors than did preoperative US and other imaging modalities. In this series, 45.9% of HCCs smaller than 3 cm and 14.2% of those between 3 and 5 cm were invisible and impalpable during laparotomy, and another 15.5% of the total of HCCs were only partially visible or equivocally palpable; thus they needed intraoperative US to make a three-dimensional localization of the tumors. We concluded that, in the resection of small HCCs, intraoperative US should serve as a routine procedure.