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Long-term follow-up revealed no case of advanced ampullary cancer and suggested that endoscopic treatment was satisfactory for the large majority of patients with ampullary adenomas.

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The effects of somatostatin-14 (S14) and somatostatin-28 (S28), a novel intestinal peptide containing somatostatin tetradecapeptide in its C-terminal position, on the bombesin-stimulated release of gastrin, insulin, and glucagon were tested. On iv infusion of bombesin, the increase in the level of glucagon was seen to be twice that of gastrin, and the insulin increase was 8 times that of gastrin. Plasma concentrations of somatostatin were not modified. S14 and S28 inhibited the release of gastrin, insulin, and glucagon; insulin release was inhibited most effectively, with glucagon release next, and gastrin release least inhibited. Based on the exogenous dose needed to produce equal effects, S28 was more potent than S14 on a molar basis, but based on the plasma concentrations needed to produce equal effects, S14 and S28 were equipotent.

Endoscopic ultrasonography is the best available method for the locoregional staging of esophageal carcinoma. Its main limitations are represented by a) tumor stenosis, b) distinguishing between malignant and benign lymph nodes, and c) distinguishing between mucosal and submucosal cancer. In untreated esophageal carcinoma, three main groups can be distinguished, based on clinical and morphological evaluation (endoscopy, abdominal ultrasound and CT). EUS is not useful when palliative treatment aiming to relieve dysphagia is the only treatment. In tumors with a superficial pattern at endoscopy, EUS is necessary to distinguish T1 from more invasive tumors, but endoscopic treatment (photodynamic therapy, strip biopsy) is indicated only in nonsurgical patients. In the last, and largest, group of tumors with no clear surgical contraindication, EUS is necessary when surgery is not the only treatment considered. EUS staging then improves patient management (surgery alone, surgery with preoperative treatment, or nonsurgical treatment; type of surgery). Moreover, it provides a good evaluation of the prognosis, and allows better follow-up after nonsurgical treatment.