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Publisher: Peytchinski, Gospodin Iliev
ISSN: 1312 773X (Online)
Issue: 2012, vol. 18, book 3;
Subject Collection: Medicine
Page: 261 - 264
DOI: 10.5272/jimab.2012183.261
Published online: 11 July 2012
J of IMAB. 2012; 18(3):261-264
INTRAOPERATIVE ULTRASOUND EXAMINATION OF HILAR CHOLANGIOCARCINOMA /TUMOR OF KLATSKIN /
Ivailo P. Vazharov1, Daniel V. Kostov2
1) Department of Gastroenterology; 2) Department of Surgery
MultiprofileHospital for Active Treatment – Varna, MilitaryMedicalAcademy – Sofia, Bulgaria.
ABSTRACT:
Purpose: To compare the opportunities of the intraoperative ultrasound examination of the liver with the preoperative imaging methods – Computer tomography (CT), Ultrasound examination (US) in detecting hepatic lesions in patients with tumor of Klatskin (hilar cholangiocarcinoma).
Patients and methods: This is a prospective study of 7 patients, which had undergone open operative intervention for tumor of Klatskin. The affecting of the liver by the tumor process was examined preoperatively with Ultrasound examination and Computer tomography with contrast amplification, and by inspection and palpation and intra operative ultrasound during the operative intervention.
Results: The maximum numbers of malignant lesions are found by IOUS - totally 21. Preoperative ultrasound found 5 lesions or 23,80% of the maximum number and preoperative CT – 9 or 33,33%. The information from IOUS changed the operative plan in 2/7 of the patients (28,57%). A biliary stent was placed under the control of IOUS in one patient with a heavy hyperbilirubinemia – 791,6 µmol/l.
Conclusions: IOUS is significantly helpful in surgery of tumor of Klatskin. Besides the precise localization and staging of the tumor the information of IOUS changes the surgical strategy in some patients.
Key words: preoperative ultrasound, Computer tomography, intraoperative ultrasound, tumor of Klatskin.
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Please cite this article as: Vazharov IP, Kostov DV. INTRAOPERATIVE ULTRASOUND EXAMINATION OF HILAR CHOLANGIOCARCINOMA /TUMOR OF KLATSKIN/. J of IMAB. 2012; 18(3):261-264. doi: 10.5272/jimab.2012183.261
REFERENCES:
1. Friman S. Cholangiocarcinoma-current treatment options. Scand J Surg. 2011;100(1):30-34. [PubMed]
2. Jang HJ, Kim TK, Wilson SR. Imaging of malignant liver masses: characterization and detection. Ultrasound Q. 2006 Mar;22(1):19-29. [PubMed]
3. Choi JY, Kim MJ, Lee JM, Kim KW, Lee JY, Han JK. et al. Hilar cholangiocarcinoma: role of preoperative imaging with sonography, MDCT, MRI, and direct cholangiography. AJR Am J Roentgenol. 2008 Nov;191(5):1448-57. [PubMed] [CrossRef]
4. Bismuth H, Colette MB: Intrahepatic cholangioenteric anastomosis in carcinoma of the hilus of the liver. Surg Gynaecol Obstet. 1975 Feb;140(2):170-178. [PubMed]
5. Sainani NI, Catalano OA, Holalkere NS, Zhu AX, Hahn PF, Sahani DV. Cholangiocarcinoma: current and novel imaging techniques. Radiographics. 2008 Sep-Oct;28(5):1263-87. [PubMed] [CrossRef]
6. Union for International Cancer Control/ (UICC): TNM Classification of malignant tumours, 7th Edition. November 2009, Wiley-Blackwell ISBN: 978-1-4443-3241-4
7. de Jong MC, Hong SM, Augustine MM, Goggins MG, Wolfgang CL, Hirose K, et al. Hilar cholangiocarcinoma: tumor depth as a predictor of outcome. Arch Surg. 2011 Jun;146(6):697-703. [PubMed]
8. Vazharov IP. Opportunities of intraoperative ultrasound in malignant liver lesions. Author’s summary of his dissertation. 2011: 23-25. http://vma.bg/doc/proceduri/Vazharov/Avtoreferat.pdf [in Bulgarian]
9. Kaiser GM, Sotiropoulos GC, Sgourakis G, Bleck J, Baba HA, Beckebaumr S, et al. Surgical treatment of Klatskin tumor: liver resection versus transplantation. Hepatogastroenterology. 2010 Nov-Dec;57(104):1337-40. [PubMed]
10. Ramos Rubio E. Radical surgery for hilar cholangiocarcinoma (Klatskin tumor) [Article in Spanish] Cir Esp. 2007 Jul; 82(1):11-5. [PubMed]
11. Ito F, Cho CS, Rikkers LF, Weber SM. Hilar cholangiocarcinoma: current management. Ann Surg. 2009 Aug; 250(2):210-8. [PubMed] [CrossRef].
Accepted for publication: 17 May 2012
Issue published online: 11 July 2012