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 cancer has not been evaluated previously.


METHODS
Between 1990 and 1995, IOUS was prospectively employed to evaluate the liver for metastases in 32 patients with resectable pancreatic adenocarcinoma. Preoperatively, all patients had computed tomography (CT) and 22 patients had CT portography.


RESULTS
At exploration, 5 of the 32 patients (15%) had extrapancreatic disease, 3 (9%) with liver implants. IOUS did not identify any additional hepatic metastases. Four preoperative studies were suspicious for metastatic disease in the liver. In these 4 patients, no hepatic metastases were identified by exploration or intraoperative ultrasound.


CONCLUSIONS
We no longer routinely perform hepatic IOUS when evaluating patients with pancreatic adenocarcinoma for pancreaticoduodenectomy. When a preoperative study indicates possible hepatic involvement, IOUS can confirm the presence or absence of liver metastases.
Finlayson
C
C
Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA.
Hoffman
J
J
Yeung
R
R
Kessler
H
H
Guttmann
M
M
Shaer
A
A
Clair
M
M
D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000556:secondary* / Q000601:surgery; D000328:Adult; D000368:Aged; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000473:pathology* / Q000601:surgery; D016577:Pancreaticoduodenectomy; D011446:Prospective Studies; D011859:Radiography; D018084:Ultrasonography, Interventional