Intraoperative ultrasonography in the surgical treatment of hepatic tumors.

Intraoperative ultrasonography was performed in 50 patients with various liver tumors; 35 hepatocellular carcinoma (hepatoma), 2 cholangiocellular carcinoma, 5 secondary liver cancer, 5 cavernous hemangioma, and 3 hyperplastic nodule in the cirrhotic liver. Various kinds of liver surgery were carried out on these patients; subsegmental resection of the liver in 19, segmentectomy in 12, hepatic lobectomy in 10, tumor extirpation in 4, and palliative surgery in 5 instances. Thirty-three of 35 hepatoma patients had associated cirrhosis of the liver. Sixty per cent of hepatomas smaller than 5 cm in diameter were invisible at surgery. Three hyperplastic nodules in the cirrhotic liver and three cavernous hemangiomas were also invisible because of the lesions being embedded in the liver parenchym . The sonographic examination proved to be a useful method not only for knowing the exact localization of invisible tumors but also for preventing vascular injury at subsegmental or segmental resection of the liver.