Role of intraoperative ultrasound of the liver with improved preoperative hepatic imaging.

Objective: To find out whether intraoperative ultrasound (IOUS) of the liver should still be considered a routine procedure for patients having hepatic resections as their preoperative investigation has become so much better with the standard use of triphasic spiral computed tomograms (CT).

Design: Retrospective study.

Setting: University medical centre, Utrecht, The Netherlands.

Patients: 26 consecutive patients undergoing liver resection.

Main outcome measures: How much additional information was given by IOUS, and its influence on operative strategy; how IOUS facilitated the hepatic resection.

Results: IOUS revealed additional information over triphasic CT in 13/26 patients, which led to a change in the surgical procedure in 4 (15%). For all 4 patients the change in surgical approach proved to be correct as judged by histology and clinical outcome. In 12 patients IOUS facilitated the resection by providing helpful three-dimensional anatomical insight.

Conclusion: Despite recent improvements in preoperative investigation, IOUS should still be recommended as a routine procedure in patients having hepatic resections. In addition to aiding the ultimate decision about which part to resect, it also gives insight into the hepatic anatomy.