Five patients with early carcinoma of the gallbladder detected by ultrasonography were studied. Three complained of non-specific upper abdominal symptoms or were asymptomatic and two had severe biliary colic. Gallstones were present in the two patients without biliary symptoms. Early carcinoma of the gallbladder was demonstrated as a polypoid tumour by ultrasound in four patients and as thickening of the gallbladder wall in one. The tumour was over 2 cm in diameter in all but one patient in whom the tumour enlarged rapidly from 5 to 10 mm. Size of the tumour and extent of spread were closely related. All but one patient underwent curative resection. Ultrasonography enhances the detection of early carcinoma of the gallbladder especially in old patients with non-specific abdominal symptoms and the operative cure rate is thereby improved.

Biopsy tissue of adult human liver was gently dissociated with collagenase followed by Dispase. By repeated low g centrifugation, a large number of almost pure, viable hepatocytes was obtained. This is the first report of a successful procedure for obtaining adult human hepatocytes for study in tissue culture. The isolated cells have the typical morphology of liver parenchyma, and these characteristics persist throughout the period of culturing. Evidence of their function is indicated by albumin synthesis. This procedure is now being used to study human hepatocyte functions in vitro and the effects of a variety of agents including carcinogens and viruses.

Difficulty in introducing a sphincterotome into the common bile duct remains a problem in the technique of endoscopic sphincterotomy. An antegrade guide passed through a percutaneous transhepatic catheter or a choledochal tube was successfully used to help retrograde insertion of the sphincterotome in 6 patients with difficult cannulation. This method is a safer and simpler alternative to precutting, decreasing the risk of acute pancreatitis. Also, when the papilla is located inside a diverticulum and difficult to reach by endoscopy, the antegrade guide is helpful for bringing it out of the diverticulum, allowing one to enter the common bile duct with the cutting probe.

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