Intraoperative sonography: clinical usefulness in liver surgery.

In the past 4 years intraoperative sonography was performed on 83 patients with primary hepatic carcinoma, 11 with benign hepatic tumor, nine with intrahepatic lithiasis, five with metastatic hepatic carcinoma, and four with other benign hepatic diseases, for a total of 112 patients. Ultrasonography detected primary carcinoma in 80 of 83 patients (96.4%) and intrahepatic metastases in 30 of 33 patients (90.9%), as confirmed later in surgical specimens. Tumor thrombi in the portal vein were detected in nine of 13 patients (69.2%). In patients with intrahepatic lithiasis and benign space-occupying lesions, residual stones could be assessed easily and the nature and location of the lesions identified. Intraoperative sonography demonstrates intrahepatic ductal structures clearly and is the final diagnostic imaging procedure before surgery.