Nutritional state in pancreatic and periampullary malignancies: influence in preoperative TNM staging compared with histopathology

Electronic Poster Abstracts complications. The third introduction of the isotopes was made on the fourth month after the operation. Results: 17 Patients were examined. All patients had an established diagnosis of pancreatic adenocarcinoma. In the first group of 9 patients underwent Whipple procedure, the second 8 patients-pylorus preserving pancreatic resection. During the preoperative phase in 10 patients was noted a slight slowdown in the evacuation of radiopharmaceuticals from the stomach (50 min.), 2 patients had the half-life period more than 80 min. In all patients during the second study was observed slowgastric emptying. In the patients group after Whipple procedure half-life of radiopharmaceuticals was 126.7 min  89 min. Patients after PPPR-118.8  44 min. During the third examination T1/2 of the stomach was 75 min  17 min in patients after Whipple. Patients who underwent PPPR, had median of gastric emptying 46  8 min. Conclusions: Patients undergoing Whipple procedure revealed the presence of gastrostasis (by entero-gastric reflux), and in patients undergoing PPPR - gastrostasis caused either anastomositis or violation of the innervation of the stomach wall.

EP04B-012 NUTRITIONAL STATE IN PANCREATIC AND PERIAMPULLARY MALIGNANCIES: INFLUENCE IN PREOPERATIVE TNM STAGING COMPARED WITH HISTOPATHOLOGY M. Bailon Cuadrado, M. Rodriguez Lopez, B. Pérez Saborido, R. Velasco Lopez, S. Mambrilla Herrero, K. T. Plua Muñiz, E. Asensio Diaz, L. M. Diez Gonzalez, D. Pacheco Sanchez, M. Gonzalo Martin and A. Barrera Rebollo General and Digestive Surgery, Rio-Hortega University Hospital, Spain Introduction: Nutritional state has been widely reported to be of capital importance prior pancreatic resection. Moreover, poor nutritional state and cachexia have been associated with advanced pancreatic cancer. However, little has been published regarding the association between hyponutrition and preoperative imaging (endoscopic ultrasonography, EUS, and computer tomography, CT) accuracy for TN stage. Methods: Retrospective cohort analysis of operated pancreatic and periampullary cancers in our HPB Surgery Unit (Rio-Hortega University Hospital, Valladolid, Spain) from January 2012 to December 2014. Inclusion criteria: preoperative nutritional evaluation including plasmatic protein, PP (cohort 1, PP 6.5 g/dL, cohort 2, PP >6.5 g/dL) and completed pancreatic resection. We analysed differences in imaging (EUS and CT) and pathologic T and N stage between cohorts 1 and 2. Statistical analysis SPSS 18.0. Results: 57 Patients underwent operation due to pancreatic and periampullary cancers of whom 16 (28.0%) were included for analysis (males 62.5%, females 37.5%, age: 68.1  7.1 years). No statistical differences have been found between EUS and histopathology TN stage neither in cohort 1 nor in cohort 2. No statistical differences have been found between CT and histopathology TN stage neither in cohort 1 nor in cohort 2.

HPB 2016, 18 (S1), e385ee601

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Conclusions: Preoperative nutritional evaluation rate is not high among our patients with resected pancreatic and periampullary malignancies. Nutritional status in terms of plasmatic protein value does not affect T and N assessment comparing preoperative image test and definitive histopathology stage.

EP04B-013 THE USE OF CT MULTIPLANAR RECONSTRUCTION TO ASSIST ULTRASOUND IN LOCALISATION OF LIVER TUMOUR D. T. L. Tam, T. P. Fung, J. S. W. Wong, S. H. Lam and T. L. Chow Department of General Surgery, United Christian Hospital, Hong Kong Introduction: Percutaneous local ablation of liver tumour is one of the treatment modalities for hepatocellular carcinoma. However, sometimes tumour may not be easily seen with ultrasound. This may be due to previous operation or due to the limited space between ribs. The use of navigation system in these situations will improve localisation of these tumours but this system is not readily available to some centres. We introduce an easy way of using Multiplanar Reconstruction (MPR) of the CT images to assist localisation of liver tumour. Method: By using thin cut CT images and using the OsiriX software, multiplanar reconstruction of the CT images will reconstruct one of the planes corresponding to the plane on the ultrasound. Even though the tumour may not be readily visible on ultrasound, it can be localized in relation to known vascular structures. Conclusion: The use of CT multiplanar reconstruction can assist ultrasound in localisation of liver tumour.

EP04B-014 RADIOLOGICAL INTERVENTION FOR HEAMOPTYSIS IN A CASE OF ACUTE PANCREATITIS e A RARE ENTITY K. Ragupathy Ragavan1, R. Vellaisamy2, A. Anbalagan2, P. Raju2, B. Duraisamy2, C. Servarayan Murugeasan2 and K. Devy Gounder2 1 Surgical Gastroenterology, Tamilnadu Dr M.G.R Medical University, India, and 2Institue of Surgical Gastroenterology, Madras Medical College, India Objectives: Heamoptysis after acute pancreatitis is a rare entity and difficult to manage. This article is to demonstrate the successful management of heamoptysis following a case of acute pancreatitis. Case report: A 39-year-old male was admitted with abdominal pain and dyspnea. On evaluation he was found to have peripancreatic fluid collection and left sided pleural effusion. Patient was managed conservatively with left sided ICD insertion. With that patient improved and discharged. One month later patient presented with heamoptysis and malena. On evaluation CECT revealed pseudo cyst in tail of pancreas with loculated collection in left pleural space. Portal Doppler revealed no evidence of splenic artery aneurysm. The patient underwent conventional angiogram which revealed normal splenic artery,