According to our data, the endoscopic stenting of the CBD might be considered as the first choice procedure in the setting of the biliary anastomotic strictures occurring after liver transplantation. It has proved to be safe and effective, avoiding the need for more invasive surgery, which in any case should be considered for nonresponsive patients.

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Our data suggest that omeprazole infusion is a valid alternative to injection treatment of non-bleeding visible vessels.

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Acute pancreatitis is a serious complication of endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy (EST). In addition, serum pancreatic enzymes increase without clinical symptoms in about 40-50% of patients undergoing these endoscopic procedures. We evaluated the potential of octreotide, a long-acting somatostatin analogue, to prevent these complications in patients who underwent EST for choledocholithiasis. 151 patients were randomly allocated to two groups (A and B). Group A was given 0.1 mg of octreotide subcutaneously 120 and 30 min before EST and four hours after; group B was given a placebo. Serum amylases (normal range 20-220 IU/l) were measured before premedication and 4, 24, and 48 hours after the end of endoscopy. After EST, the increase in the mean serum amylase was greater in the control group, but the difference was statistically significant only at the 48-hour measurement. There were five cases of acute pancreatitis in each group, with a trend (but not statistically significant) toward less severe pancreatitis in the treated group. In the control group, one patient with acute pancreatitis died. In conclusion, octreotide does not seem to prevent acute post-EST pancreatitis.

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