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In a double-blind, prospective, randomized trial, 63 patients with actively bleeding gastric erosions were treated with somatostatin (31 patients) or secretin (32 patients). Both drugs were administered by intravenous infusions for 48 or 72 h. The active bleeding and the effect of the therapy was endoscopically established. Somatostatin had a significantly (p < 0.05) better effect on the control of bleeding (29 vs. 23 patients), transfusion requirements (5.8 vs. 7.4 units, p < 0.01) and on the need of surgery (1 vs. 6 patients, p < 0.01). The mortality and the rebleeding rate did not differ between the two groups. The results show that somatostatin is more effective than secretin in the control of active bleeding form gastric erosions.

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The bile duct can be visualized by injecting contrast material directly into the biliary system. The authors describe three cases of inflammatory, postsurgical granuloma in the vicinity of the cystic stump that gave rise to obstructive jaundice and the symptoms of choledocholithiasis, following bile duct operation. For diagnosis, endoscopic retrograde cholangio-pancreatography (ERCP) and percutaneous transhepatic cholangiography (PTC) were used. The importance of this change, the diagnosis, differential diagnosis and treatment are discussed.