<p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</p> <p>Ultrasonic dissetion (USD) and intraoperative ultrasonography (IOUS) have shown encouraging results
in a retrospective analysis of 109 patients with benign or malignant liver disease. Of 109 patients assessed
between 1980 and 1993, 84 were resected: 27 by finger fracture technique (FFT) and 57 by USD. Hospital
mortality was 4.8% (4/84) and 30-day mortality was 6.0% (5/84). Overall morbidity was 48.8% (41/84)
and liver related morbidity (hepatic bleeding, sepsis, and bile leak) was 34.5% (29/84); of the 29 patients,
5 required re-operation. Liver complications occurred in 12/27 (44.4%) in the FFT group as opposed to
17/57 (29.8%) in the USD group. The incidence of postoperative hepatic bleeding was significantly less
by USD than by FFT(<italic>p</italic>=O.03). As well, intraoperative blood loss (<italic>p</italic>=O.01)number of intraoperative
blood units used (<italic>p</italic>=0.002), and postoperative length of stay (<italic>p</italic>=O.O09) have been significantly reduced
by USD. IOUS was used on 64 patients. Not only has it improved the sensitivity (99%) and specificity
(98%) for detection of hepatic neoplasms, it has also helped increase the precision and accuracy of
anatomical tumour localization. As a result, 11/64 patients (17.2%) had their preoperative plans
changed: 8 were abandoned and 3 were revised. In summary, USD has significantly reduced
intraoperative blood loss and hence reduced the number of intraoperative transfusions, incidence of
postoperative complications and postoperative length of stay. IOUS should be routinely employed in
patients undergoing liver resection since it provides critical information that could obviate oncologically
useless resections.</p>
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HPB Surg. 1996; 9(3):121-128