Hypothesis: Although advances in endoscopic procedures have provided alternative options for relieving biliary obstructions, the overall chance of cure for patients with benign biliary stricture is the same using surgical or endoscopic treatment.

Self-expanding metal stents (SEMS) can be used to treat patients with symptomatic anastomotic complications after colorectal resection. In the present case series, 16 patients with symptomatic anastomotic stricture after colorectal resection were treated with endoscopic placement of SEMS. Seven patients had a "simple" anastomotic stricture and nine patients had a fistula associated with the stricture. The anastomotic fistula healed without evidence of residual stricture or major fecal incontinence in seven of the nine patients. Overall the anastomotic stricture was resolved in 10 of the 16 patients. SEMS placement represents a valid adjunctive to treatment in patients with symptomatic anastomotic complications after colorectal resection for cancer.

An analytical procedure applicable to restricted sample sizes was developed and applied to the analysis of 30 chemical elements in colorectal biopsies of healthy patients. Acidic microwave digestion processed

SUMMARY Basal frequency of sphincter of Oddi phasic contractility has been repeatedly measured during endoscopic manometry and reported to range, in control subjects, from (M±SE) 3-0±0-6 to 7*5±0*7 c/min. Recently, high frequency (>8 c/min) phasic contractions or absence of phasic activity were recorded in patients with postcholecystectomy or pancreatic complaints, possibly suggesting a sphincter of Oddi dysfunction. In the present study, sphincter of Oddi (biliary tract) phasic contractility was measured by perendoscopic manometry in 13 subjects without specific clinical symptoms of biliopancreatic disease and with a normal common bile and pancreatic duct at ERCP. Four T-tube patients with no evidence of common bile duct stones or papillary stenosis were studied for comparison (transductal sphincter of Oddi manometry). Basal frequency was found to range from 0 to 7 c/min (M±SE: 2-99±0.46) in perendoscopic manometry (85 min of recording time) and from 0 to 12 c/min (2.0±0.3) in transductal manometry (2546 min of recording time). Long lasting transductal recordings also showed that frequency of activity derived from the sphincter area varied cyclically in close relation with the duodenal migrating motor complex. It is concluded that the sphincter of Oddi in man is likely to participate in the interdigestive gastrointestinal motor activity and that short perendoscopic recordings may not be representative of the overall sphincter of Oddi activity.The sphincter of Oddi is a specialised and, to a large extent, embryologically independent' muscular structure surrounding the terminal end of common bile and pancreatic duct. It determines a resistance to flow toward and from the duodenum and displays rapid closing and opening movements. As shown by cinefluorography opening is accompanied by an apparently free flux of ductal contrast medium into the duodenum. Closing movement begins with a ring like contraction at about half way of the sphincter, then the ducts obliterate and ampulla empties distally. Both movements appear to be relatively' independent from duodenal motor activity.A quantitative evaluation of sphincter of Oddi motility is possible by intra-Oddian manometry, and the endoscopic cannulation of the papilla allows measurements to be made in intact subjects and in both the biliary and pancreatic tract of the sphincter.Address for corrcspondence: Aldo Torsoli MD,