Exclusion reason was no IC at RY anastomosis in 10 patients, unrecognizing RY in 4 patients, inaccessibility RY in 2 patients, absence of judge in 3 patients. Accuracy rate in total was 77.3% (58/75). Accuracy rate in TG group and in non TG group was 78.3%(9/12), 77.8%(49/63) respectively (P = 0.833). Insertion time was 39.7 min in correct group, 56.6 min in incorrect group (P = 0.023). Conclusion: In conclusion, accuracy rate of IC method in identifying

the afferent limb was 77%. Accuracy rate was no significance between in TG group and non learn more TG group. Insertion time in correct group was 17 min shorter than in incorrect group. Key Word(s): 1. double-balloon ERCP; 2. indigo carmine; 3. insertion time Presenting Author: WEN HSIN HUANG Additional Authors: CHUN FU TING, CHENG JU YU, CHI YING

YANG, CHENG YUAN PENG Corresponding Author: WEN-HSIN HUANG Affiliations: China Medical University Hospital, China Medical University Hospital, China Medical University Hospital, China Medical University Hospital Objective: Adenomas of the major duodenal papilla are not common. Surgical resection is usually performed as a definitive treatment. Endoscopic snare papillectomy (ESP) provides an endoscopic option. The aims of this study was to assess the technical feasibility, clinical outcome, and adverse events of ESP in comparison to surgical treatment of patients with adenomas of the major duodenal papilla. Methods: Between November 2004 and buy Tanespimycin June 2014, forty-five patients (24 men and 21 women; median age 65.66 ± 12.84 years, range 38–92 years) with adenomas of the major duodenal papilla at ERCP were retrospectively reviewed. Fifteen patients undergoing ESP (Group I) and fifteen patients undergoing surgical

resection (13 Whipple resection and 2 transduodenal local resection) (Group II) were enrolled in the study. Results: Except for tumor size (19.14 ± 6.88 mm in Group I and 32.47 ± 8.97 mm in Group II), there were no significant difference between two groups in clinical characteristics. ESP was technically feasible in 14 (93%) patients. Eleven of 15 (73%) patients were successfully treated with one tumor removal procedure. In Group selleckchem I, four uremic patients (27%) suffering from GI bleeding and bacteremia after tumor resection required blood transfusion and intravenous antibiotics therapy. One of 4 patients expired because of severe bacterial sepsis. In Group II, 7 patients (47%) had wound leakage, intra-abdominal abscess, and sepsis requiring drainage and antibiotics treatment. Two of 7 patients had septic shock and acute respiratory failure requiring endotracheal intubation. The duration time of hospitalization was 7.64 ± 4.41 days in Group I and 33.53 ± 20.03 days in Group II (P < 0.0001). In the duration of follow-up (46.7 ± 36.04 months), two (13%) residual adenoma were detected in the ESP group. Conclusion: Compared with surgery, ESP group had shorter hospital stay and fewer complications.