To analyze the effect of IOUS on surgical decision making, we performe
d a retrospective study of 45 patients who had exploratory laparotomy
and IOUS for liver neoplasms. Preoperative lesion detection was compar
ed with intraoperative findings. The effect of IOUS on the choice of s
urgical procedure was analyzed. Preoperative imaging detected 67% of l
esions, 78% when combined with surgical inspection and palpation, and
97% were recognized by IOUS. Surgery was modified in 23 of 45 cases (5
1%); 19 of those 23 cases (83%) were based on IOUS findings alone. IOU
S demonstrated superior lesion detection over noninvasive preoperative
liver imaging, and IOUS significantly affected surgical decision maki
ng.