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The growing rod technique is currently one of the most common procedures used in the management of early onset scoliosis. However, in order to preserve spine growth and control the deformity it requires frequent surgeries to distract the rods. Magnetically driven growing rods have recently been introduced with same treatment goal, but without the inconvenience of repeated surgical distractions. One of the limitations of this technical advance is an increase in radiation exposure due to the increase in distraction frequency compared to conventional growing rods. An improvement of the original technique is presented, proposing a solution to the inconvenience of multiple radiation exposure using ultrasound technology to control the distraction process of magnetically driven growing rods.

We present the case of a 60-year old male with a follicular pattern of multifocal invasive papillary thyroid carcinoma who had undergone total thyroidectomy. During post-surgical follow-up with I-131 scan, a I-131 deposit was observed in the upper left hemiabdomen. Due to suspicion that it could be a metastasis, an ultrasound and CT scan were performed, with the subsequent diagnosis of a left simple serous renal cyst. Once confirmed, drainage was performed under ultrasound control, obtaining I-131 in the analysis of its content.

Surgical ligation of a patent ductus arteriosus (PDA) in small premature infants may be performed with open thoracotomy or video-assisted thoracoscopic surgery (VATS). The LigaSure vessel sealing system (Valleylab/Tyco Healthcare, Boulder, CO) is increasingly being used because of its effectiveness in promoting coagulation. Moreover, for PDA ligation using VATS, the LigaSure system seems more practical than vascular clips. Among 81 children, including 43 premature infants weighing less than 1000 grams operated on for PDA in our institution, one 9-month-old boy weighing 7600 grams underwent PDA ligation using a LigaSure grasp. The perioperative aspect of the closed ductus was satisfactory. The following day, however, ultrasound control revealed recanalization of the ductus, and the child had to undergo a second operation. At operation, the ductus wall adventia and media appeared to have retracted to both extremities, leaving the intima exposed and pulsating under the blood pressure. The PDA ligation was repeated, but in conditions of severe hemorrhage. The LigaSure system works by fusing collagen in the tissue. However, because the ductus wall has less collagen than any other vessels in the body, the LigaSure vessel sealing system is not reliable for PDA ligation.

Aims: The analysis of laparoscopic operations in treatment of chronic pancreatitis. Patients & methods: In our clinic there were performed 32 laparoscopic interventions for chronic pancreatitis and its complications. Results: Laparoscopic interventions were performed in 32 cases: cystogastrostomy10, cystoduodenostomy2, cystojejunostomy3, cystectomy1, longitudinal laparoscopic pancreaticojejunostomy 2, the Beger procedure without proximal pancreatoenterostomy 2 and the Berne modification 10. In all the cases of laparoscopic procedures the communication of a cystwith the main pancreatic duct were confirmed by preoperative biochemical and cytologic analysis of cystic fluid taken under the ultrasound control puncture. By the patient with a cyst located in the tail of the pancreas, the bleeding from the splenic artery required to convert the operation. In another patient laparoscopic longitudinal pancreatovirsungotomy and pancreatic resection were performed due to the impossibility of adequate cyst drainage in the hamulus region of the pancreas which required conversion of the operation into open.Mean operating timewas 295(260-360). Blood loss was 105±59 ml. Postoperative hospital stay was 8 days. Conclusion: Clinical experience in the use of laparoscopic procedures in chronic pancreatitis treatment supports the conclusions of other authors concerning the advantages of laparoscopic techniques which are of better tolerance and which shorten hospital stay. The application of minimally invasive surgery techniques may be effective on condition that there is a thorough selection of patients taking into account the anatomic features of the pancreas and its duct system in every individual case.

Summary Surgical procedures are considered the gold standard treatment of hydatid cysts. We report the first case of percutaneous treatment of a complex hydatid cyst of the liver, using radio frequency as a scolecidal agent in a 28-year-old man. The procedure was performed under real-time ultrasound control and with the patient under general anesthesia. Injection of alcohol was performed at the end of the procedure to induce retraction of the residual cavity. The percutaneous procedure was associated with oral albendazole therapy. Six months after the procedure, the patient was in very good condition. Liver and blood tests were normal and the cyst cavity was reduced. Further studies are required to define the indication of this new therapeutic strategy of hydatid cyst.

Introduction Type II endoleak with high risks of complications can be managed by endovascular catheterization or direct percutaneous approach if standard endovascular techniques failed as it is reported in our observation. Report A 79-year-old patient was treated two months earlier by stent-graft for a retroperitoneal rupture of a right common iliac artery aneurysm. The 2 months follow-up CT-scan showed an endoleak from the right hypogastric artery without clearly outflow vessel. Ultrasound guidance was used to access the endoleak, which was then embolized with coils under fluoroscopy. Discussion This case illustrates the possible advantages of this technique in the treatment of endoleak.

RISK FACTORS OF CHOLELITHIASIS RELAPSE AFTER LITHOTRIPSY AND DURING PROPHILACTIC TREATMENT WITH BILE ACIDS: PRELIMINARY RESULTS OF TWO-YEARS FOLLOW-UP STUDY V. Isakov l, T. Petukhova, M. Brekhova, A. Mironov, I. Ivanikov Central Hospital Medical Centre of RF President Adm. Dep., Department of Gastroenterology, Moscow Russia. 1MONIKI, Moscow, Russia. The aim: To establish risk factors of cholelithiasis relapse after lithotripsy and during long-term prophylactic therapy with bile acids. 205 patients (Male/Female=55/150; mean age 45,6 yrs) after successful gallbladder lithotripsy were enrolled for the prophylactic therapy with ursodeoxycholic acid (dosage 10mg/kg per day) for 24 months with ultrasound control every 3 months. During the follow-up period 128 (62,4%) patients relapsed. Multivariate analysis revealed that age (Table), 20% increase of body mass index, 10% increase of blood cholesterol indelmndently increase risk o f relapse of cholelithiasis. Age group Patients in remission after 2 years (%) p