Salminen P M, Höckerstedt K, Edgren J, Scheinin T M, Tierala E
IVth Department of Surgery, Helsinki University Hospital, Finland.
Acta Chir Scand. 1990 Apr;156(4):329-32.
Ultrasonography of the liver was performed on 27 patients during laparotomy for liver lesions--11 primary and 13 metastatic mainly colon/rectum malignancies, and three benign conditions. Supplementary information on the liver parenchyma was provided in 11 cases (41%) in which the surgical strategy was decided simply by inspection and palpation of the liver. Ultrasound was most valuable for visualizing the vascular anatomy of the liver, giving clarification in 18 cases (66%), especially the relationship of tumor to portal and hepatic veins. This was decisive for the surgical strategy in four cases, enabling resection in two and modifying planned procedure in two. In a case of polycystic liver, ultrasonography imaged deep-lying cysts and aided the fenestration procedure. Liver resection was performed in 16 cases without operative mortality. Hepatic ultrasonography is useful for determining tumor spread, but of even greater value for the determination of strategy by clarifying tumor/vascular anatomic relationships.
对27例因肝脏病变接受剖腹手术的患者进行了肝脏超声检查，其中11例为原发性病变，13例主要为结肠/直肠恶性肿瘤的转移灶，3例为良性病变。在11例（41%）病例中，肝脏实质的补充信息有助于手术策略的制定，这些病例中手术策略仅通过肝脏的视诊和触诊来决定。超声对显示肝脏血管解剖结构最有价值，18例（66%）病例中得到了明确，尤其是肿瘤与门静脉和肝静脉的关系。这在4例病例中对手术策略起了决定性作用，2例得以进行切除，2例改变了计划的手术方式。在1例多囊肝病例中，超声对深部囊肿进行了成像并辅助了开窗手术。16例进行了肝切除术，无手术死亡病例。肝脏超声检查有助于确定肿瘤扩散情况，但通过明确肿瘤/血管解剖关系来确定手术策略的价值更大。
