Abstract
We studied on the extent of cancer invasion of biliary tract using intraoperative ultrasonography in 23 patients, including 6 gall bladder cancer, and 17 bile duct cancer (3 nodular type, 9 nodular invasive type, and 5 invasive type based on the General Rules on Cancer of Billiary Tract of Japanese Society). The ultrasound apparatus used in this study was Aloka SSD 256, 330 (5MHz and 7.5MHz) with immersion and direct contact methods. These ultrasonograms gave us the cancer invasion as irregular high echo zone extending the primary lesion, especially remarkable in the horizontal spreading aspect of bile duct wall. This procedure enabled us to have a more correct diagnosis of the extent of cancer invasion than the intraoperative cholangiography, so that this was not only very useful, but aslo necessary in the curative operation. Additionally to make sure, we did same trial on 10 cases of the Borrmann type 4 stomach cancer, supposedly showing the same scirrhous invasion in the pathology. The findings of these cases showed that such high echo area was identified with thick fibrous layer of the invasive cancer of biliary tract. We conclude that intraoperative ultrasonography give us a more correct diagnosis of the extent of bile duct cancer invasion than the intraoperative cholangiography and other methods, and that this procedure is not only very useful, but also necessary in the curative operation.
