Thesis (M.Sc.) - Cairo University - National Cancer Institute - Department of Oncology (Surgical)

Background: CT is the most common staging investigation in hepato-biliary-pancreatic surgery.The superiority of Intraoperative ultrasound (IOUS) over preoperative radiologic images and intraoperative inspection and palpation was demonstrated in numerous studies. IOUS may play an important role in open and laparoscopic abdominal surgery. It can satisfy the surgeon{u2019}s need to characterize lesions, assess their locoregional extension and determine disease staging by providing direct contact with the tissue and real-time imaging data.Objectives: This pilot study explores the additional information obtained from IOUS compared to preoperative imaging and to evaluates the effect of this additional information on surgical strategy. Its safety and time efficiency are also assessed. Patients and methods: A single center prospective pilot study. All patients underwent routine scanning of the abdomen and pelvis as a method of preoperative staging of the general abdominal cavity, including the liver and pancreas. A detailed checklist for IOUS application was created for this study and was executed before, during and upon completion of resection so no time was wasted at operating room. Imaging were available in OR for an immediate comparative analysis after performing IOUS. Changes in the surgical staging or management of the disease were noted. Related morbidity and procedure were also assessed.Results: Among 20 patients, IOUS demonstrated seven (25%) additional lesions compared to preoperative imaging, additional beneficiary information in 10 (50%) of patients and changed the management strategy in seven (35%) of patients. The average duration of IOUS procedure was 17 ± 5 min. No complications related to IOUS use

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