RIOC during LC is a safe, accurate, quick, and cost-effective method for the detection of bile duct anatomy and stones. A highly disciplined performance of RIOC can minimize potentially debilitating and hazardous complications of bile duct injury.

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SUMMARY Gastric emptying of solid meals labelled with 129Cs was studied in patients for up to one year after vagotomy and antrectomy or after proximal gastric vagotomy. Significant delay was found one month after vagotomy and antrectomy but this had returned to normal by six months. No delay was found after proximal gastric vagotomy.The effect of posture on gastric emptying was also studied in the same subjects. No significant differences were found between gastric emptying in the supine or sitting positions after solid meals.The technique of monitoring clearance from the stomach of a meal containing a radioactive tracer has been widely used in recent years in patients with a variety of gastric disorders (Jones, Clark, Kocak, Cox, and Glass, 1970;Tinker, Kocak, Jones, Glass, and Cox, 1970; Colmer, Owen, and Shields, 1973; and van Dam, 1974). Early workers used external counters but the use of computerized gamma-camera systems is becoing more common (Cowley, Vernon, Jones, Glass, and Cox, 1972; Hancock, BowenJones, Dixon, Dymock, and Cowley, 1974).The recent study of van Dam (1974) indicates that the range of emptying rates is large in a group of normal subjects but that individuals appear to have characteristic and repeatable values. However, the effects on gastric emptying rates of a number of important variables remain to be fully resolved and there is no standard technique for the acquisition and presentation of data. This paper presents the results of a comparative study of the effects of truncal vagotomy and antrectomy and of proximal gastric vagotomy (Amdrup and Jensen, 1970;Johnston and Wilkinson, 1970) on gastric emptying. Emptying patterns have been investigated by comparison of measurements performed during the period from one month to one year following operation.Among the factors which may affect the results of such measurements are the character of the meal, the posture of the subject, the length of time of the observations, and the mode of presentation of the

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Carcinoma of the stomach in the young is rare and often difficult to diagnose. At this stage the carcinoma appears usually to be superimposed on a previously existing peptic ulcer. In this instance the case reported is that of a 19-year-old woman who gave a 2½-year history of gastric pain. A diagnosis of duodenal ulcer with pyloric hypertrophy was made and she was treated conservatively at first, but the symptoms persisted. She was admitted to hospital and an antecolic Polya gastrectomy was performed. Subsequent histological examination revealed a carcinoma of the stomach.