The laparoscopic ultrasound probe is inserted through the right lateral port. The examination starts with scanning the left lateral lobe of the liver, examining segments I, II, and III in turn. Examination of the right lobe follows (A-1).
The hepatoduodenal ligament is examined with identification of the common hepatic duct, common bile duct, portal vein, and hepatic arteries (A-2). Visualization of these structures is aided through the use of color flow Doppler. The pancreas is then examined by slowly rotating the head of the transducer. The relationship of the tumor to the pancreatic duct and surrounding peri-pancreatic vessels (portal vein, superior mesen-teric vein, superior mesenteric artery) can be determined.
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