渡辺 義二, 植松 貞夫, 竜 崇正, 古川 隆男, 菊池 俊之, 尾崎 正彦, 佐藤 博

Yoshiji WATANABE, Sadao UEMATSU, Munemasa RYU, Takao FURUKAWA, Toshiyuki KIKUCHI, Masahiko OZAKI, Hiroshi SATO

千葉大学医学部第二外科

Second Department of Surgery, Faculty of Medicine, University of Chiba

キーワード : ultrasound, liver tumor, hepatocellular carcinoma, hepatectomy, intraoperative US examination

Recently, ultrasonography (US) and computed tomography have been used for diagnosis of liver diseases, especially hepatocellular carcinoma, metastatic liver tumor, hepatolithiasis etc. and have proved to be highly accurate in diagnosing the location and size of tumor and stone in the liver.
We have employed US examination during operation using a real time 2.4 MHz puncture transducer and have performed ultrasonically guided hepatectomy in four patients (3 patients; hepatocellular carcinoma combined with liver cirrhosis, 1 patient; hepatocellular carcinoma without liver cirrhosis).
The advantages of US examination during operation are;
1) Discovery of tumor nodules combining with liver cirrhosis and being the deep position from liver surface can be performed far correctly.
2) Relationship between the tumor and hepatic vein, portal vein can be made far accurately than preoperative US examination.
3) By using a real time puncture transducer, introducing puncture needle will be guide for hepatectomy and hepatectomy can be performed safely and certainly.
At present we are developing a new type of real time transducer (a small-sized one having a center hole) for the intraoperative US examination.