Defining the anatomical borders of the hepatic segments by intraoperative ultrasound examination

The purpose of this study is to evaluate the potentialities of the intraoperative ultrasound (IOUS) for demarcation of the hepatic segments during anatomic resection of the liver in cases of primary and metastatic carcinoma of the liver. We performed demarcation of segments with methylene blue for anatomic resection of the liver in 10 patients – 4 with primary hepatic carcinoma and 6 with metastatic for a period of two years. The apparatus used was Aloka SDD 4000+, provided with UST-MC11-8731 Aloka Ultrasound electronic convex intraoperative transducer. Under the control of IOUS we injected methylene blue in a segment / or sub segment for a sub segment resection/portal branch near the lesion. This intervention procedure under the control of IOUS may be applied as a routine practice for anatomic demarcation of segments of the liver in cases of primary and metastatic hepatic carcinoma.