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

Surgical management of intraabdominal hydatid disease

This study was performed on 11 patients [3 males and 8 females with an age ranging between 23 and 65 years] with intra-abdominal hydatid cysts who presented during a period of four years. Hydatid cysts were intrahepatic in nine cases [one of them had multiple cysts]; in the other two cases, the kidney was affected. Complement fixation test accuracy was 63.6% only, while the accuracy of ultrasonography and CT scan was 90.9% and 85.7%, respectively. Calcification in plain X-ray was seen in two cases only. All patients were operated upon under the cover of antibiotics and mebendazole. Different surgical techniques were used according to the site and size of the cysts and the organ involved. Ultrasonography is the main diagnostic tool in intra-abdominal hydatid disease, while CT scan is reserved for more complicated cases. Surgery is still the mainstay in management and the surgical technique used must be designed according to the results of the investigations for each case individually