Background: Tumors of the head of the pancreas and of the periampullary region, similar nosologic entity, represent the fourth most common cause of cancer death. These tumors are characterized bt high mortality rate associated with a low percentage of surgical resectability. Vasculary involvment is, in our experience, one of the criterias of exclusion for curative surgical resection. For this reason reginal pancreasectomy don’t show, in several case records, comforting datas about survival. Methods: From 1995 to 1998 we intoduced in the operative practice the colordoppler ultrasonography to diagnose vasculary involvment.We evaluated twenty patients that previously were canditated for surgical therapy consisting in a duodenal-pancreasectomy.All the patients were staged by preoperative abdominal
ultrasound, E.R.C.P., CT, and angio M.R.I..In no one of these patientswere founded signes of vasculary involvment. We recognized by intraoperaitve color-doppler ultrasound three microscopic invasions of splenomesenteric portalvasculary axis. Results: U.S. I.O. C.D. in our case reports has underlined a sensibility and specificity of 100%.It has dicovered, also, a false positive for neoplastic trombosys, and a case of false negative. Conclusions Intraoperative ultrasound shows a high sensibility about the intraoperative staging for the biliopancreatic tumors. The study about the possible vasculary involvment is helped by the application of the colour in terms of an high sensibility and diagnostic care