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PURPOSE: The aim of the study was to estimate the value of intraoperative ultrasound (IOUS) in detecting the hepatic metastases of pancreatic carcinoma. MATERIAL AND METHODS: A total of 16 patients, 6 women and 9 men, were considered suitable for hepatic resection of pancreatic carcinoma with transcutaneous ultrasound examination (US) and contrast enhanced computer tomography. Intraoperatively, they are examined by inspection, bimanual palpation and US. Both number and localization of the lesions were compared. IOUS influence on the operative plan was evaluated. RESULTS: IOUS detected 60 liver metastases which were histologically confirmed. Preoperative US examination found out 28 lesions or 46.66% of all lesions and the preoperative computer tomography (CT) did 29 ones or 48.33%. The information gained from IOUS changed the operative plan in 8 out of 16 patients. A biliary stent was placed under IOUS control in one patient with severe hyperbilirubinemia of 466 µmol/L. CONCLUSION: IOUS detects by more than two times hepatic metastases in comparison to the preoperative US and CT. It enables the change of the medical strategy in half of the patients and in the patients with mechanical icterus. Besides it allows stent placement to alleviate patient's status. This leads us to the conclusion that IOUS should be applied as a routine practice in hepatic resections of pancreatic carcinoma metastases. Scripta Scientifica Medica 2013; 45(1): 62-65.

Does intraoperative ultrasound examination improve the detection of hepatic metastases of pancreatic carcinoma?