术中B型超声检查在肝癌手术中的应用

85例肝癌病人在术中进行了术中B超检查,其结果与术前B超、CT进行了对照。作者发现(术中B超检查)对大的肝癌结节(主瘤)显示三者无统计学差异;对肝内转移灶(子瘤)显示分别为90.32％、22.58％、16.18％;门脉干支内癌栓显示为88.88％、22.22％、11.11％,对胆管内癌栓分别为83.33％、33.33％、33.33％。本组肿瘤切除68例,切除率80％,死亡率1.17％。术中B超检查可清晰显示癌周血管,有利于判断肿瘤能否切除,减少术中血管损伤,检出19例病人肝实质内子瘤31个,15例得到合理切除,小肝癌定位5例,顺利切除。

Use of Intraoperative Ultrasonography During Surgery of Liver Cancer

Intraoperative ultrasonography (IOUS) was performed in 85 patients with liver cancer. The results of preoperative ultrasonography (US) and computed tomography (CT) were compared. There was no significant difference In detecting the primary lesion of liver cancer. The sensitivity of IOUS, US and CT in detecting the intrahepatic metastatic lesions (daughter node) was 90.32% . 22.58% and 16.8%, respectively; in detecting the portal vein tumour thrombi was 88.88% , 22.22% and 11.11% , respectively; and in detecting the bile duct tumour thrombi was 83.33% , 33.33% and 33.33% , respectively. In sixty-eight patients hepatectomy were performed. The resected rate was 80% , and mortality 1.17% , IOUS could show the blood vessels around tumour clearly, and be useful to determine the resectability of liver cancer, to reduce surgical injury of blood vessels. Thirty-one intrahepatic daughter nodes were detected by IOUS in 19 cases, and in 15 cases were resected. IOUS could determine the position of tumour and direct resection in 5 cases of small liver cancer.