IMPACT OF INTRAOPERATIVE ULTRASONOGRAPHY ON SURGERY FOR CYSTIC LESIONS OF THE PANCREAS

The impact of intraoperative ultrasonography (IUS) on surgery for cyst ic lesions of the pancreas (CLPs) has not been fully clarified. Twenty patients with CLPs, including 5 pseudocysts and 15 true cysts, were s canned intraoperatively to evaluate the utility and practicality of IU S for CLPs. In four of the five patients with pseudocysts and two with retention cysts, the operative procedures were performed under IUS gu idance, In one with a pseudocyst, IUS showed that the cyst did not inv olve the pancreas, and subsequently cystectomy without pancreatic rese ction was necessary, In one of the two patients with mucin-producing c ystadenocarcinomas, IUS demonstrated a skip lesion in the duct of the pancreatic tail, which contributed to changing the operative procedure from pancreatoduodenectomy to total pancreatectomy; in the other, IUS showed that the lesion was localized in the body of the pancreas, and subsequently segmental pancreatectomy was carried out instead of sche duled pancreatoduodenectomy or distal pancreatectomy. Thus in these th ree patients the operative procedures were changed in light of the IUS findings, In the remaining 11, although IUS visualized CLPs clearly, it added no new information relevant to the operations. We conclude th at IUS contributes to performing surgery for certain types of CLP, suc h as pseudocysts with severe inflammation, retention cysts with nonpal pable or invisible small cysts, mucin-producing cystadenocarcinomas, a nd possibly other lesions.