Ultrasonography of the Liver

Until recent years, the surgeon who was interested in hepatic surgery had, as tools for intraoperative exploration of the liver, only his own eyes, his hands, or opacification of the biliary ducts (cholangiography) or vascular structures (ileoportography). His eyes allowed discovery of superficial lesions, his hands gave clues as to deeper ones. Biliary or vascular opacification enabled detection of lesions close to those structures that were either invading or compressing them, but certain small lesions may have evaded careful, well-managed attempts to detect them. The rise of intraoperative ultrasonography has presented the surgeon with a powerful additional weapon. Sonographic examination has proved to be as important for the clinical diagnosis of parenchymatous lesions as it is for the therapy of such lesions.