Evaluation of selective endoscopic cholangiopancreatography [ERCP] in patients under going laparoscopic cholecystectomy: a prospective study

This study included 90 patients with symptomatic gallstones presenting for laparoscopic cholecystectomy [LC] during a period of two years. In 19 patients, the criteria of selection for ERCP were fulfilled. Cannulation of the common bile duct [CBD] was achieved in all the 19 cases. ERCP was positive for stones in 13 cases. ERCP with or without endoscopic sphincterotomy [ES] was successful in clearing up the CBD in 11 out of the 13 positive cases. LC was performed for 88 cases [71 cases with no ERCP + 6 cases with negative ERCP + 11 cases with successful ERCP], while open surgery for CBD exploration and cholecystectomy were performed in the 2 cases where ERCP failed to clear up the CBD. No mortalities were reported and the morbidity rate was 10.5%. During a follow up period of 6-12 months [mean = 10], there were no reported missed stones in the CBD

Transvaginal versus transabdominal ultrasonography in the evaluation of induced ovulation and its complications

The aim of this work was to evaluate the efficiency of TVS as compared to TAS in the monitoring of induced ovulation. The study included 35 patients undergoing hormonal therapy using hCG to induce ovulation. Each patient was examined at least four times during the menstrual cycle using both modalities. There was better correlation between the results of TVS and the estimated serum estradiol level in the study of five cases. In two cases TVS failed to show one or both ovaries, while TAS could do that. In conclusion, except in few cases, TVS is superior to TAS in the detection of the number, size and sharpness of the follicles during monitoring of induced ovulation specially in obese patients and in those with history of pelvic surgery and/or failed previous induction of ovulation. It avoids a full urinary bladder, an irritating request for both the patient and the radiologist, reduces the patient's discomfort at the time of the examination

Transvaginal ultrasound - guided needle aspiration of ovarian cysts

The aim of this work was to try the therapeutic ultrasound guided transvaginal approach using this technique. Six premenopausal women with the age range of 15-35 years all having simple unilateral ovarian cysts were subjected to transvaginal US guided total fine needle [22 G] aspiration. Certain criteria were established for the selection of the cases including premenopausal age, clear content and thin wall of the cysts with no solid component. The procedure was carried out in the theater under i.v. Analgesia with the needle mounted to the intravaginal probe using a special device. The total time of the procedure was 15 minutes. The procedure was well-tolerated by all the patients. Prophylactic hospital stay was 24 hours. Cytological examination of the aspirate was follicular cyst in three cases and corpus luteum cyst in the other three. Only one out of five cases showed recurrent cyst in a period of three months follow up. It was concluded that, when certain criteria for selection of the cases are fulfilled, the transvaginal approach for US-guided therapeutic needle aspiration of ovarian cysts is a safe and useful therapeutic alternative to reduce the number of laparotomies performed in these cases