黒肱 敏彦¹, 山下 裕一¹, 君付 博¹, 平城 守¹, 林 譲二¹, 堀内 彦之¹, 酒井 浩一¹, 掛川 暉夫¹, 町 淳二¹, SIGEL Bernard²

Toshihiko KUROHIJI¹, Yuichi YAMASHITA¹, Hiroshi KIMITSUKI¹, Mamoru HIRAKI¹, Johji HAYASHI¹, Hiroyuki HORIUCHI¹, Kohichi SAKAI¹, Teruo KAKEGAWA¹, Junji MACHI¹, Bernard SIGEL²

¹久留米大学第1外科, ²ペンシルバニア医科大学外科

¹First Department of Surgery Kurume University School of Medicine, ²Department of Surgery Medical College of Pennsylvania

キーワード : Intraoperative ultrasonograph, Color Doppler imaging

Intraoperative color Doppler imaging (I.C.D.) was evaluated as a new modality during a total of 155 various type of operations, which included 4 gastrointestinal, 11 thoracic, 102 hepatobilibly, 18 pancreatic 14 vascular and 6 other operations. It's value was assessed in terms of the ability of intraoperative diagnosis prior to major tissue dissection, the guidance of surgical procedures, and the confirmation of the completion of operation. In 140 of 155 operations (90%), new imaging information that was not known preciously was obtained by ICD. ICD was useful to guide the surgical procedure in 94 of 155 operations (61%), particularly useful for hepatobiliary operations. The value of confirming the completion of operation by ICD was found specially after vascular reconstructive operations. In addition ICD was used for examination of intratumoral blood flow. A total of 92 nodules in 51 hepatocellular carcinomas were examined. Intratumoral pulsatile blood flow was visualized by ICD in 55% OF 92 nodules; 70% of nodules greater than 3 cm in diameter and 29% of nodules even smaller than 1 cm. ICD has a unique capacity of providing blood flow information in addition to anatomical information. From the present study, we concluded that this new modality may have a potential to be a valuable tool during various type of surgical procedures.