Conclusion: In conclusion, OTCS system is a very significant device that can be used as conservative treatment of the pancreatic fistulae or gastro-intestinal perforations, avoiding the surgery marked by high mortality. Key Word(s): 1. Over-the-scope clips; 2. Fistulization; 3. Acute pancreatitis; 4. Endoscopic Treatment; Presenting Author: NAMQ NGUYEN Additional Authors: LEANNE CX-4945 research buy TOSCANO, MATTHEW LAWRENCE, RAJVINDER SINGH, PETER BAMPTON, TAMARAL DEBRECENI, RICHARDH HOLLOWAY, MARKN SCHOEMAN Corresponding Author: NAMQ NGUYEN Affiliations: Royal Adelaide Hospital; Lyell

McEwin Hospital; Flinders Medical Centre Objective: The use of intravenous sedation with benzodiazepine and opioid for colonoscopy in subjects with morbid obesity and/or obstructive sleep apnoea (OSA) is considered unsafe with significant risk of respiratory depression. These high-risk subjects are recommended to have anaesthesia-assisted colonoscopy. Patient-controlled analgesia with portable inhaled methoxyflurane (Penthrox®) has been recently shown to be feasible and safe for colonoscopy in unselected subjects with no risk of

respiratory depression. Penthrox®, thus, may be a more attractive alternative for colonoscopy in these high-risk subjects. This study aims to evaluate the feasibility, safety and post-operative management of Penthrox® as an analgesic agent for performing colonoscopy in subjects with morbid obesity and/or OSA. Methods: 25 morbidly obese subjects (12M : 13F; learn more age: 60.3 ± 9.9 yrs; BMI:

41.0 ± 6.3 kg/m2), of which 8 had co-existing OSA, underwent colonoscopy with inhaled Penthrox® as a method of discomfort relief during colonoscopy. Patients with renal and liver diseases were excluded. Details on the degree of discomfort and anxiety before, during and after the colonoscopy were assessed using the visual analogue scale (VAS) pain score and State-Trait Anxiety Inventory Form Y-1 (STAI Y-1) score. Details on the performance of the colonoscopy as well as the occurrence of adverse events were also documented. Vital signs and oxygen saturation during the procedure were monitored every 3 minutes. Results: Colonoscopy was successfully and safely completed in all (100%) subjects D-malate dehydrogenase with no adverse effects such as respiratory depression, arrhythmia or hypotension. Inhaled Penthrox® did not affect the performance of colonoscopy with caecal arrival time of 8 ± 1 min, withdrawal time of 8 ± 1 min and 52% polyp detection rate (13/25). The mean VAS pain score during the procedure was 3.6 ± 1.1 (0–10 scale). The overall satisfactory score was 98 ± 5 (0–100 scale) with 24/25 subjects willing to use Penthrox® for colonoscopy again. All subjects were alert during and at the completion of the colonoscopy, and were discharged at 28 ± 5 min after the completion of the procedure.