Therefore, PCM has two advantages including maintenance of the thick submucosal layer preventing the leakage of injection solution, and providing good traction thus stretching the submucosal tissue and facilitating the submucosal dissection. Adjusting the approach angle of the knife to be tangential to the muscle layer is easy with this method. The aim of this study is to evaluate the safety and efficacy of PCM compared with conventional ESD. Methods: From August 2008 to July 2013, a total of 37 duodenal neoplasms (cancer PF-02341066 supplier 20, adenoma 17) in 34 patients

were treated by ESD at Jichi Medical University Hospital. We selected two groups, patients treated by PCM (P-group) or by conventional ESD (C-group). The resection speed (resection area/operating time, mm2/min), en-bloc resection rate, complete resection rate, and perforation rate were analyzed retrospectively. Results: The resection speed was faster in the P-group than the C-group (20.1 vs 15.2 mm2/min, P = 0.15). The en-bloc resection rate and complete resection rate were higher in the P-group than in the C-group (100% and 87.5%, P = 0.17, 85.7% and 71.4%, P = 0.22, respectively). The perforation rate was lower in the P-group than in the C-group (6.7% Mdm2 inhibitor vs 19.0%, P = 0.27). Conclusion: For each

parameter evaluated, PCM was better than a conventional ESD, trending toward significance, enabling better and safer ESD procedures. These results establish feasibility and support further evaluation of this technique. Key Word(s): 1. endoscopi submucosal dissection pocket-creation method Presenting Author: SHINICHI MORITA

Additional Authors: YASUAKI ARAI, MIYUKI SONE, HIROAKI ISHII, SHUNSUKE SUGAWARA, YASUNARI SAKAMOTO, TAKUJI OKUSAKA, SHIGETAKA YOSHINAGA, YUTAKA SAITO Corresponding Bay 11-7085 Author: SHINICHI MORITA Affiliations: National Cancer Center Hospital, Tokyo, Japan, National Cancer Center Hospital, National Cancer Center Hospital, Tokyo, Japan, National Cancer Center Hospital, National Cancer Center Hospital, National Cancer Center Hospital, National Cancer Center Hospital, National Cancer Center Hospital, Tokyo, Japan Objective: We report our initial experience of antireflux metal stent (ARMS) placement for distal malignant biliary obstruction. Methods: Twenty-six patients with unresectable distal malignant biliary obstruction received endoscopic ARMS placement between February and June 2014 (Male/female = 15/11; Median age = 71 years old [43–87]). Causes of stricture were pancreatic cancer (n = 22), lower biliary tract cancer (n = 2), gallbladder cancer (n = 1) and ampullary cancer (n = 1). Sixteen patients (62%) had duodenal invasion.