title: Ultrasound-guided liver resection: Early experience in a district general hospital.
abstract: BACKGROUND
  Intraoperative ultrasonography (IOUS) is the gold standard for tumor staging and operative decision making in liver surgery. Providing dynamic information on tumor-vessel relationships and distribution of intrahepatic veins, IOUS is also an important support for guiding the resection. Few authors report an extensive use of IOUS-guidance as a safe and effective approach. The aim of this study is to investigate the short-term results of an early experience of ultrasound (US) guided liver resection.
  
  
  METHODS
  From December 2005 to December 2007 an extensive use of IOUS-guided resection was applied in 11 consecutive patients (8 males and 3 females; median age 74 years). Perioperative data were collected prospectively to assess the influence of this approach on mortality, morbidity and early recurrence.
  
  
  RESULTS
  Four patients had hepatocellular carcinoma, 4 liver metastases, 1 peripheral cholangiocarcinoma, 1 hemangioma and 1 inflammatory pseudotumor. A median of 1 (range: 1-4) nodule per patient was resected. Median lesion size was 44 mm. Liver procedures included: 3 wedge resections, 3 subsegmentectomies, 4 segmentectomies and 3 bisegmentectomies. Median blood loss was 235 ml. Median surgical margin in cancer patients was 5 mm (range: 1-12). An average of 1 unit of blood transfusion was administered in 5 patients. Median postoperative hospital stay was 9 days. There was no mortality. Major complications occurred in 1 patient and minor complications in 5 patients. During a median follow-up of 14 months no recurrences were observed.
  
  
  CONCLUSIONS
  In this study, use of IOUS-guided liver resection performed in a district general hospital proved to be a safe and effective approach in terms of short-term outcome.
authors: Department of General and Emergency Surgery, Hospital Villa Scassi, Genoa, Italy.
authors: P
authors: P
authors: Grondona
authors: C
authors: C
authors: Meola
authors: F
authors: F
authors: Floris
authors: R
authors: R
authors: Masini
authors: E
authors: E
authors: Brignole
authors: F
authors: F
authors: Quidaciolu
keywords: Hepatocellular carcinoma; Intraoperative ultrasonography; Liver metastases; Liver resection
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