Methods: 12 patients underwent endoultrsound guided endoscopic necrosectomy and temporary cystogastrostomy for infected pancreatic necrosis by using CSEMSs. Patient details, disease severity scores, scores for severity assessed at CT, treatment procedures, length of hospital stay, and outcome

for patients undergoing endoscopic therapy were recorded. Patients proceed to intervention if infection is strongly suspected on clinical and radiological grounds or is confirmed bacteriologically. After the necrosis cavity had been accessed, with the assistance of endoscopic ultrasound, a large orifice was created and necrotic debris was removed using special CHIR-99021 price short fully covered 15 mm diameter SEMS with large flares was deployed across the tract under Romidepsin concentration radiological control. Completeness of the necrosectomy

procedure was ascertained by visualization of a clear pseudocyst cavity on endoscopy. Results: A total of 12 patients (10 men, 2 women; median age 39, range 19 – 76) who were treated successfully. Median APACHE 2 score on presentation was 11 (range 3 ± 18). Two patients presented with organ failure and needed intensive care. Necrosis was successfully treated endoscopically in all patients, requiring a median of 2 endoscopic interventions (range 1 ± 4). The tissue samples obtained at the first necrosectomy confirmed infection in 12 patients. Complication included superinfection in patient who made an uneventful recovery. After median of 5 weeks the metal SEMS was extracted by endoscopy. The patients have remained

asymptomatic and median follow-up was 4 (2 ± 11) months. Nabilone Conclusion: Endoscopic necrosectomy and temporary cystogastrostomy with self-expanding metallic stent approach is feasible, safe, and effective in patient with infected pancreatic necrosis. The benefits of this endoscopic approach using fully covered self-expandable metallic stent in terms of less morbidity is conceivable and our report demonstrates that such an approach is feasible. Key Word(s): 1. EUS; 2. Pancreas; 3. Pseudocyst; 4. Stent; Presenting Author: KAZUSHIGE UCHIDA Additional Authors: YURI FUKUI, TAKEO KUSUDA, MASANORI KOYABU, HIDEAKI MIYOSHI, TSUKASA IKEURA, MASAAKI SHIMATANI, MAKOTO TAKAOKA, KAZUICHI OKAZAKI Corresponding Author: KAZUSHIGE UCHIDA Affiliations: Kansai Medical University Objective: Type 1 autoimmune pancreatitis (AIP) is characterized high serum IgG4 levels and infiltration of IgG4-positive cells. We have reported that regulatory T cells (Tregs) may regulate IgG4 production in type 1 AIP. Some patients with pancreatic ductal adenocarcinoma (PDA) show an increased serum IgG4 concentration. In this study, we have studied the IgG4 positive cells and correlations between IgG4-positive cells and Tregs in patients with PDA. Methods: A total of 21 PDA and nine AIP patients were enrolled in our study.