Missed cancers were a frequent finding in patients with oesophageal and gastric cancer who had undergone previous endoscopy, and errors by the endoscopists accounted for the majority of missed lesions. This study emphasizes the importance of identifying signs of early cancers and of having a low threshold for performing multiple biopsies of any suspicious-looking lesion.

Formal risk assessment of the presence of CBD stones using this scoring system is simple and may be used for preoperative selection of patients for biliary tract imaging by magnetic resonance cholangiography or ERCP.

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Laparoscopic cholangiography is a safe procedure. Use of an image intensifier should be the preferred method of obtaining images. Metal cannulas are more likely to obscure the ductal system. The proximity of the clip on the cystic duct to the CBD highlights the potential for injury caused by electrocautery or erroneous clip application.

Background Some authorities recommend that colorectal cancer should be treated in specialist units but evidence that non-specialist units demonstrate comparatively poor results may be lacking. Methods Between 1987 and 1991,267 patients were operated on by four general surgeons, none of whom was a specialist in colorectal surgery. Procedure-related complications, postoperative mortality and disease-related survival rates were analysed.