INTRAOPERATIVE ULTRASOUND DOES NOT IMPROVE DETECTION OF LIVER METASTASES IN RESECTABLE PANCREATIC-CANCER

BACKGROUND: In colorectal cancer, intraoperative ultrasound (IOUS) is superior to other imaging studies in characterizing hepatic metastases , The value of IOUS in detecting liver metastases from pancreatic canc er has not been evaluated previously, METHODS: Between 1990 and 1995, IOUS was prospectively employed to evaluate the liver for metastases i n 32 patients with resectable pancreatic adenocarcinoma. Preoperativel y, all patients had computed tomography (CT) and 22 patients had CT po rtography. RESULTS: At exploration, 5 of the 32 patients (15%) had ext rapancreatic disease, 3 (9%) with liver implants. IOUS did not identif y any additional hepatic metastases, Four preoperative studies were su spicious for metastatic disease in the liver, In these 4 patients, no hepatic metastases were identified by exploration or intraoperative ul trasound, CONCLUSIONS: We no longer routinely perform hepatic IOUS whe n evaluating patients with pancreatic adenocarcinoma for pancreaticodu odenectomy, When a preoperative study indicates possible hepatic invol vement, IOUS can confirm the presence or absence of liver metastases. (C) 1998 by Excerpta Medica, Inc.