Cuesta M A, Meijer S, Borgstein P J, Sibinga Mulder L, Sikkenk A C
Department of Surgery, Free University Hospital, Amsterdam, The Netherlands.
Br J Surg. 1993 Dec;80(12):1571-4. doi: 10.1002/bjs.1800801226.
Despite the advances made since the introduction of ultrasonography, computed tomography and magnetic resonance imaging, a wide discrepancy may occur between preoperative and peroperative staging of gastrointestinal malignancy with liver and peritoneal metastases. Diagnostic laparoscopy performed immediately before a planned laparotomy can provide valuable information for the accurate assessment and appropriate management of some forms of gastrointestinal malignancy, especially that of the liver and pancreas. For evaluation of small liver and retroperitoneal malignancies, intraoperative ultrasonography performed by laparotomy is of proven value. It is now technically possible to perform ultrasonography through a laparoscopic cannula using high-resolution ultrasonographic transducers. This combination of laparoscopy and ultrasonography was studied in 25 patients with established liver lesions, carcinoma of the gallbladder or pancreatic cancer. Additional information leading to a change in surgical approach was obtained in 20 patients. Laparoscopic ultrasonography, although still in a preliminary phase of development, is a simple and reliable technique that will contribute to more accurate staging of intra-abdominal malignancy.
尽管自超声检查、计算机断层扫描和磁共振成像技术问世以来取得了诸多进展，但胃肠道恶性肿瘤伴肝转移和腹膜转移的术前和术中分期之间仍可能存在较大差异。在计划进行剖腹手术前立即进行诊断性腹腔镜检查可为某些形式的胃肠道恶性肿瘤，尤其是肝脏和胰腺的恶性肿瘤的准确评估和适当治疗提供有价值的信息。对于评估小的肝脏和腹膜后恶性肿瘤，通过剖腹手术进行术中超声检查已证明具有价值。现在从技术上来说，使用高分辨率超声换能器通过腹腔镜套管进行超声检查是可行的。对25例已确诊有肝脏病变、胆囊癌或胰腺癌的患者进行了腹腔镜检查与超声检查相结合的研究。20例患者获得了导致手术方式改变的额外信息。腹腔镜超声检查虽然仍处于初步发展阶段，但却是一种简单可靠的技术，将有助于更准确地对腹内恶性肿瘤进行分期。
