Impact of intraoperative ultrasound on pancreatic tumor resectability

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Abstract

Background
Usually, there is no intraoperative image guidance performed during abdominal exploration of pancreatic tumor. Intraoperative ultrasound (IOUS) enhances the visualization of pancreatic tumor during resection, so it needs to be investigated in detail.
Objective
The aim of the study was to assess the impaсt of IOUS on preoperative surgical strategy. The authors compare IOUS findings with the operative assessment of the radicality of resection and vascular contact.
Patients and methods
The study proceeded in the Department of Surgery, Theodor Bilharz Research Institute from 2016 to 2019. This prospective cross-sectional study was to assess the impact of IOUS on preoperative surgical planning and to assess whether the radicality and vascular affection of the tumor would be correctly evaluated or not. IOUS was conducted on 38 patients by a competent surgeon during abdominal exploration of the pancreatic tumor and was then compared with intraoperative assessment.
Results
IOUS affects surgical planning in 66.6% of cases. Radical resection was achieved in 36 out of 38 malignant tumors (94.7%). By using preoperative imaging vascular contact was assessed correctly in 68.4% of the patients compared with 89.4% by using IOUS.
Conclusion
IOUS assessment in pancreatic tumors changed the surgical strategy in 21% of the patients. So, the authors can use IOUS to assess the resectability of the tumor and the possibility of vascular contact during surgical resection.

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