Intraoperative ultrasonography and surgical strategy in hepatic resection: What difference does it make?

Jrearz, Ricky; Hart, Richard; Jayaraman, Shiva

doi:10.1503/cjs.016914

Cited by 18 publications

(11 citation statements)

References 19 publications

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“…However Richy and his colleagues study on IOUS in 2015 reported 17% change in surgical strategy [14]. This may be due to preoperative MRI were not done routinely to all our cases.…”

Section: Discussionmentioning

confidence: 81%

Effect of Intraoperative Ultrasonography on Change of Surgical Decision for Patients with Hepatocellular Carcinoma

Mogahed¹

2016

IJRRT

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Background: Hepato cellular carcinoma (HCC) is one of the most common cancers worldwide. Intra operative ultrasonography (IOUS) is considered an indispensable operative procedure for intra operative decision-making and guidance of surgical procedures. IOUS had changed hepatic surgery dramatically because it was the only modality that was capable of delineating and examining the interior of the liver during surgery especially after incorporation of color Doppler imaging and laparoscopic ultrasound into IOUS in1990s. IOUS can accurately define the hepatic segmental boundaries as well as the tumor boundaries. The use of IOUS started in Japan and from there it spread worldwide allowing for the development of different therapies to treat patients with HCC. Our aim was to determine if IOUS can changes surgical decision in hepatic resection for HCC. Methods:We retrospectively analyzed 48 consecutive liver resections performed at multiple centers over 3 years. Preoperative surgical decision was based on ultrasonography, computed tomography and/or dynamic magnetic resonance imaging (DMRI). The size, location and number of lesions were determined by IOUS and compared with preoperative imaging. Reviewing the operative report helped determine if new IOUS findings led to changes in surgical strategy. Pathology reports were analyzed for margins.Results: This study was conducted on 48 HCC consecutive patients 27 males and 21 females with age range from 49 to 67 years. Hepatic resection was decided as the treatment of choice for all patients. During operation direct inspection and palpation of the liver followed by IOUS were done. The operative decision was changed in 17 patients (35.4%), this was due to finding new additional tumors in 13 cases, and 4 cases showed change in tumour size on background of cirrhosis. Conclusion:We found that IOUS findings directly changed the operative surgical decision in 35.4 % of cases. Surgery was more accurately performed with IOUS. Despite the improvement of preoperative imaging modalities, IOUS can correctly define the hepatic segments as well as the extent of a tumor so it help for best operative decision in hepatic resections.

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“…However Richy and his colleagues study on IOUS in 2015 reported 17% change in surgical strategy [14]. This may be due to preoperative MRI were not done routinely to all our cases.…”

Section: Discussionmentioning

confidence: 81%

Effect of Intraoperative Ultrasonography on Change of Surgical Decision for Patients with Hepatocellular Carcinoma

Mogahed¹

2016

IJRRT

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“…IOUS has been considered as an essential adjunct in hepatic resection. This can provide precise information about the location of the liver lesions and their association with vital anatomical structures, thereby helping guide the surgical strategy [12]. The use of the IOUS offers a chance of cure to an increasing proportion of patients who were considered only for palliative care a few years ago [13].…”

Section: Discussionmentioning

confidence: 99%

“…The use of the IOUS offers a chance of cure to an increasing proportion of patients who were considered only for palliative care a few years ago [13]. IOUS directly alters the preoperative surgical plan by approximately 17% [12]. Previous reports have indicated that it would be very beneficial to switch the scanning of the ultrasonic probe from normal to inverse modality, in order to display the usual appearance of the intrahepatic anatomy of a patient with SIT on the screen [3].…”

Section: Discussionmentioning

confidence: 99%

Right Hemihepatectomy via an Anterior Approach for Hepatocellular Carcinoma in a Situs Inversus Totalis Patient

Zhang

et al. 2020

Case Rep Gastroenterol

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Situs inversus totalis (SIT) is a rare congenital condition in which the usual position of the organs is reversed from left to right as a mirror image of the normal situation. Due to the abnormal transposition, this represents a technical challenge for the surgeon. In the present study, right hemihepatectomy via the anterior approach was performed for a 68-year-old hepatocellular carcinoma (HCC) patient with SIT. SIT was diagnosed by chest X-ray and computed tomography. The tumors were located in segments VIII and VI of the liver, and there was no metastasis to the lymph nodes and distant organs. Hemihepatic vascular inflow occlusion was performed using the selective intra-Glissonian approach. The middle hepatic vein was preserved under the guidance with intraoperative ultrasonography. The present case suggests that right hemihepatectomy via the anterior approach may be a safe, feasible, and effective procedure for HCC patients with SIT.

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“…Also intraoperative Doppler ultrasound was used to identify the boundaries of pancreatic mass and to determine the transection line of the pancreas, as well as to identify the splenic vessels. 46,47 We herein present the first case of totally robotic distal pancreatectomy, left hemihepatectomy and splenectomy for PNET with no severe perioperative comorbidity and optimal oncologic outcomes. As the tumor was stable and localized in just pancreas and liver, she was offered surgery with both curative and cytoreductive intent.…”

Section: Discussionmentioning

confidence: 99%

The First Case Report of Robotic Multivisceral Resection for Synchronous Liver Metastasis from Pancreatic Neuroendocrine Tumor: A Case Report and Literature Review

Calin

Sadiq

Arevalo

et al. 2016

Journal of Laparoendoscopic & Advanced Surgical Techniques

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Liver metastases in PNETs are considered an adverse factor. Aggressive surgical management is a mainstay. The laparoscopic approach to pancreatic or hepatic surgery is difficult in inexperienced hands with steep learning curve. The recent robotic system seems to overcome many limitations. This is the first case of robotic multivisceral resection for synchronous liver metastasis from PNET. Concurrent primary tumor resection with hepatectomy offers potential curative intention.

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Intraoperative ultrasonography and surgical strategy in hepatic resection: What difference does it make?

Cited by 18 publications

References 19 publications

Effect of Intraoperative Ultrasonography on Change of Surgical Decision for Patients with Hepatocellular Carcinoma

Effect of Intraoperative Ultrasonography on Change of Surgical Decision for Patients with Hepatocellular Carcinoma

Right Hemihepatectomy via an Anterior Approach for Hepatocellular Carcinoma in a Situs Inversus Totalis Patient

The First Case Report of Robotic Multivisceral Resection for Synchronous Liver Metastasis from Pancreatic Neuroendocrine Tumor: A Case Report and Literature Review

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