الفهرس 
ULTRASOUNDOnly 14 pages are availabe for public view
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Abstract
IOUS is a useful method that helps solve problems in hepatobiliary surgery, during liver resection, and in a variety of therapeutic and diagnostic procedures in laparotomy. This study aimed to assess the role of intraoperative ultrasound in hapato-biliary surgery. This study included 50 patients who were examined in the Tanta University hospitals, surgery department. They were all clinically fit for surgery and were examined by multi-detector CT and / or MRI for hepatobiliary assessment The main results of our study included 1-Our results on the patient age cleared that, the patients that suffered from hepatobiliary lesions their age ranged from 19 – 67 year and most of them their age from 40 – 60 year with a mean value of 45.79 year. 2-Our results about the sex of the patients cleared that, the higher number observed in males than females. 3-Our results on hepatic lesions indicated that, the hepatic carcinoma of a higher incidences, followed by CBD obstruction due to pancreatic head masses, followed by hepatic hemangiomas, CBD obstruction due to ampullary mass, CBD obstruction due to distal CBD stones, while, the lower hepatic lesions incidences observed in hepatic metastasis and CBD obstruction due to distal CBD mass (cholangiocarcinoma). 4-Our results cleared that, the characters of hepatic lesions include hepatocellular carcinoma, IOUS guided marking of the satellite lesions to be included in the resected area with a safety margin, IOUS detected new lesions at other segments which were ablated using Habib needle, a focal lesion inseparable from the GB, also, the results cleared that, the size of the newly discovered lesions range from 3 mm to 18 mm. 5-Also, our results on hepatic metastasis cleared that, the metastatic deposits originated from GIST tumors and the IOUS showed two lesions with no newly detectable lesions. IOUS used to mark the extension of the lesions. The lesions were removed with a safety margin using IOUS guidance. 6-The results of hepatic Hemangioma cleared that, the hemangiomas observed in two cases of examined patients. 1 case with Giant right lobe hemangioma diagnosed with preoperative Triphasic CT. The role of intraoperative U.S. was to mark the extension of the lesion & relation to nearby vessels, right hepatectomy was done, The other case showed large left lobe hemangioma diagnosed with preoperative triphasic CT & MRI, IOUS was used to guide RF ablation using Habib needle. 7-Our results on the hepatic cyst cleared that hydatid cysts observed in one case and was diagnosed by preoperative CT as an abscess versus hydatid cyst. IOUS confirmed the typical appearance of shrunken membrane of hydatid organism, resection of the cyst with a safety margin was done using IOUS guidance. 8-The results of cases of biliary obstruction cleared that, the Biliary obstruction reached to 9 cases of obstruction due to pancreatic head masses was found at 3 cases, in two of them IOUS showed no hepatic metastatic deposits & were operated (Whipple’s operation) 2, while in the third case showed small hepatic metastatic deposits, so the case was considered inoperable (Grade 4). 9-Our results on distal CBD obstruction due to distal CBD strictures cleared that, were noticed in 6 of examined cases who were preoperatively diagnosed as distal CBD obstruction due to distal CBD strictures and it included 1 case showed small pancreatic head mass (was not visible at preoperative imaging), 1 case showed irregular thickening of the distal CBD (proved pathologically to be cholangiocarcinoma), 2 cases showed small ampullary lesions (proven to be ampullary carcinomas by preoperative endoscopy) and 2 cases showed distal CBD obstructing small stones (were not visible at preoperative imaging). 10-Our results concluded that, IOUS can be used effectively for detection of new findings in patients, confirmed diagnosis & guided the resection at all examined cases.