Ultrasound laparoscopy

The association of ultrasound and laparoscopy represents an excellent diagnostic alternative for a deep surface study of digestive viscera.
The main aim of ultrasound laparoscopy is detecting local or spread advanced illnesses that have not been detected yet in the radiologic or endoscopic explorations due to their reduced size or complex localization.
The most usual prescriptions that our Department advices for digestive apparatus tumors are the following:

Esophagus/Stomach

Presurgical staging of esophageal-gastric carcinoma
Evaluation after chemoradiotherapy. (post- chemoradiotherapy evaluation)
Perigastric and periesophagic biopsies of celiac trunk adenopathy
Peritoneal biopsies
Liver metastasis detection

Pancreas/Billiary tree

Presurgical staging of bilio-pancreatic tumors
Evaluation after chemoradiotherapy (post- chemoradiotherapy evaluation)
Biopsy of local and regional adenopathies
Localization of small pancreatic tumors of neuroendocrine lineage
Biopsy of pancreatic mass
Liver metastasis detection
Choledocolithiasis detection during laparotomic cholecystectomy

Liver

Presurgical staging of liver tumors
Location of the number, size and vascular-biliary connections of primary and secondary liver tumors
Evaluation after chemotherapy
Assesment of portal hypertension degree
Biopsy of local and regional adenopathies
Biopsy of liver tumors
Biopsy of liver parenchyma

Colon-Rectum

Colorectal carcinoma presurgical staging
Evaluation after surgical treatment or chemoradiotherapy
Evaluation of peritoneal relapses
Biopsy of adenopathies and perirectal mass
Peritoneal biopsies
Hepatic metastasis detection

Extradigestive pathology

Presurgical staging of extradigestive carcinoma suspected of being diseminated in the peritoneum and/or affecting the lymphatic glands
Biopsy of adenopathies of unknown origin
Evaluation of biopsy of retroperitoneal mass
Hepatic metastasis detection

Therapeutic laparoscopic ultrasound

Ethanolization of primary and/or secondary liver tumors
Radiofrecuency ablative treatment for primary and secondary liver tumors
Radiofrecuency ablative treatment for primary pancreatic tumors

ADVANTAGES

It permits a precise individualization of the oncologic treatment in patiens with malignant digestive tumors.
It performs a precise staging of malignant digestive tumors and ensures the performance of adjuvant and neoadjuvant chemotherapic treatment in patients suspected of having advanced tumors.
It prevents patients with disseminated processes, from undergoing unnecessary surgery.
It globally reduces their stay at hospital.
It reduces expenses which derive from the treatment of patients with digestive tumors.

Clinical Cases:

Clinical Case 1

Cholecystocolic fistula

holecystocolic fistula