[Intraoperative echography in biliopancreatic surgery].
Intraoperative sonography (I.O.S.) with the use of high-frequency probes placed in direct contact with structures in exploration assures a more diagnostic accuracy. I.O.S. is particularly useful in bilio-pancreatic surgery for a more precise diagnostic valuation and an excellent surgical approach. It is fundamental in the lithiasis of the biliary duct, especially hepatic lithiasis, microlithiasis, obstruction of common bile duct of uncertain cause and during laparocholecystectomy. In pancreatic surgery I.O.S. is of great usefulness in the study of acute and chronic pancreatitis and their complications, cysts, pseudocysts and cystic tumors. I.O.S. plays important role both in exocrine pancreatic carcinomas for a correct staging, and resectability decision, and in endocrine functioning tumors, permitting the location of some lesions of little dimension and eventual hormone secreting hepatic or lymph nodal metastases. In laparoscopic mini-invasive surgery, I.O.S. substitutes the palpatory sense of touch in the location and study of anatomic structures, reducing the risks of iatrogenic lesions and allowing, diagnostic accuracy even in some underestimated pathologies.