• Yuta Kobayashi, Kiyohiko Omichi, Yoshikuni Kawaguchi, Junichi Arita, Nobuhisa Akamatsu, Junichi Kaneko, Yoshihiro Sakamoto, Kiyoshi Hasegawa, and Norihiro Kokudo.
• Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
• HPB (Oxford). 2018 Jan 1; 20 (1): 93-99.

BackgroundReal-time tissue elastography during open hepatectomy facilitates the differential diagnosis of liver tumors by providing information on elasticity. This study investigated the utility of intraoperative real-time tissue elastography (IORTE) during laparoscopic hepatectomy (LH).MethodsBetween 2012 and 2014, IORTE was performed during LH for 21 hepatocellular carcinomas (HCCs), 16 adenocarcinomas and 5 other tumors in 32 patients. The elasticity images were classified into six categories according to the modified criteria on the elasticity type of liver tumors, in which type 1 tumors show more strain than the surrounding liver and type 6 tumors no strain. The concordance of the IORTE findings with those of the pathological examination of the tumors was assessed (The registration no. 1418).ResultsAmong the 21 HCCs, 20 were classified as "HCC pattern" (type 3, 4, or 5), resulting in a sensitivity of 95.2%, a specificity of 66.7% and an accuracy of 81.0%. Ten out of the 16 adenocarcinomas were classified as "adenocarcinoma pattern" (type 6), resulting in a sensitivity of 62.5%, a specificity of 92.3% and an accuracy of 81.0%.ConclusionIORTE is feasible and provides useful information on the elasticity of liver tumors in LH, in which conventional tumor palpation is difficult.Copyright © 2017 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

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