INTRAOPERATIVE ULTRASONOGRAPHY OF LIVER - DETECTION OF OCCULT LIVER-TUMORS AND TREATMENT BY CRYOSURGERY

A prospective study of 110 patients undergoing liver surgery was under taken to evaluate the usefulness of intraoperative ultrasonography (IO US) and cryosurgery in treating primary and metastatic liver tumors. T he diagnoses were colorectal cancer (n = 72), hepatocellular carcinoma (n = 15), ovarian cancer (n = 8), cholangiocarcinoma (n = 4), and oth er tumors (n = 11). IOUS results were compared with preoperative CT sc an angioportography. IOUS detected 37 lesions not seen on CT in 21 pat ients (19%) and 13 lesions not detected by bimanual palpation in 6 pat ients (5%). IOUS-assisted cryosurgery was carried out to ablate unrese ctable liver tumors in 21 patients (19%). At median follow-up of 14 mo nths, 5/21 patients (24%) achieved complete response; 24 and 52% of pa tients recurred in the liver and systemically, respectively. Thus, IOU S is useful in detecting occult liver tumors and in providing assistan ce in tumor ablative therapies. Cryosurgery is useful in controlling s ome of the unresectable liver tumors, but the 76% recurrence rate impl ies the need for an effective regional and systemic chemo/immunotherap y.