Abstracts / Pancreatology 13 (2013) S2–S98 S45

interrupted suture sequentially, which approximate jejunal serosa topancreatic capsule, thus allowing invagination of pancreatic stump intojejunum. 2. Omental patch: A strip of omentum is prepared and patchedsurrounding P-J, isolating this anastomosis from free abdominal cavity, andespecially important vessels. 3. Duodenojejunostomy (D-J): Before anas-tomosis, clamped duodenal resection margin is first cauterized for he-mostasis and sealing the wall into one layer. Then inner layer ofanastomosis with running suture is placed, taking bites of the single layeron duodenal side and full thickness bites of bowel wall on jejunal side.Outer layer is performed with continuous Lembert sutures. 4. Intraluminaldrainage: A nasogastric tube is deeply placed into the afferent limbthrough D-J, with its end near P-J, serving as an external drainage tube.

Results:Ourmodifications confer advantages of technical convenience.With increased technical precision, better outcomes are guaranteed.

Conclusion: Precise manipulations and good quality should always beemphasized in PPPD.

PI-91 Abstract id: 21.

Is pancreaticogastrostomy a safe procedure?

Deena Hadedeya, Saud Almuhammadi.

King Faisal Specialist Hospital & Research Center-Jeddah, Saudi Arabia

Introduction: Pancreaticoduodenectomy is treatment of choice forperiampullary tumors. This procedure carry a significant risk and mor-bidities. Most of them are related to pancreatic anastomotic failure. Forthat many techniques has been established to decrease the morbidity rate,pancreaticogastrostomy is one of those techniques.

Aims: evaluate the pancreaticogastrostomy procedure afterpancreaticoduodenectomy

Patients & methods: Design: Retrospective review was done for allpatient who diagnosed with periampullary tumor between 2008 to 2012.Setting: king Faisal Specialist Hospital & Research Center- Jeddah, SaudiArabia. Outcome Measures: Indication for surgery, intra-operative andpost operative variables, operative technique and post-operativecomplications.

Results: In group of patient who underwent pancreaticogastrostomy(n¼20) including 10 males and 10 females, the mean age was 56.2 years.The histopathology post operatively showed 4 benign tumors and 16malignant tumors, with mean size of tumor 3.39 cm in diameter. Themedian hospital stay was 10.8 days with median survival months were13.05 months. The complications from pancreatecogastrostomy followingpancreaticoduodenectomy has been calculated as following 5% of the pa-tients developed biliary leak, 10% experienced delayed gastric emptying,5% were having intra-abdominal collection, 15% were having woundinfection, 5% developed wound dehiscence, 15% of the patients developedatelectasis, 5% diagnosed with DVT and 10% with PE, 10% of the patientwere died due to intraoperative hemorrhage as a result of porta hepatisinjury. No one of our patient developed pancreatic leak, acute pancreatitisnor cholingitis.

Conclusion: Pancreaticogastrostomy is a safe procedure with a rela-tively low mortality and morbidity rate. It should be considered as asuitable choice after pancreaticoduodenectomy.

PI-92 Abstract id: 199.

Pancreatic cancer: does irreversible electroporation improve thequality of life and the survival in local advanced pancreatic adenocar-cinoma? Report of a pilot case

Antonio Braucci, Antonello Niglio, Carlo Molino.

Cardarelli Hospital, Naples, Italy

Introduction: Current strategy for local advanced pancreatic adeno-carcinoma (LAPC), based on chemotherapy and radiation therapy, shows

poor outcome. A novel form of tissue ablation has been proposed in thetreatment of solid tumors with promising results: irreversible electropo-ration (IRE). The technique uses high voltage pulses applied to the targettissue to induce cells’ apoptosis.

Aims: We aim to show the efficacy and safety of IRE as a palliativetreatment on clinical outcome of LAPC.

Patients & methods: A 59-year-old caucasic man diagnosed inJanuary 2012 with a stage III (T4N1M0) LAPC of the body-tail (60x30mm)encasing the superior mesenteric vessels and the small gastric curveunderwent a 6 months neo-adjuvant gemcitabine-based chemotherapyand was planned for Whipple procedure. Since the tumor was stillunresectable, US-guided IRE using the NanoKnife System by Angiody-namics has been performed.

Results: Postoperative course was uneventful and the patient wasdischarged six days after the treatment. The follow up at one month, 3 and6 months showed a CT-scan-documented reduction of the primitive mass(40x22mm VS 60x30mm). CA 19.9 levels’ trend showed also a decrease.After 15 months from the diagnosis the patient is still alive in a state ofmental and physical wellbeing.

Conclusion: IRE promises encouraging results in local control ofLAPC. The technique has shown to improve both the overall survivaland the quality of life compared with previous palliative strategies.Further studies are needed to elucidate the real advantages of thisinnovative technique and its future application even in the manage-ment of resectable pancreatic adenocarcinomas instead of conventionalsurgery.

PI-93 Abstract id: 145.

Characteristics of patients with chronic pancreatitis and pancreaticcancer

Snezana Lukic 1, Dragan Popovic 2, Aleksandra Sokic Milutinovic 2, DjordjeKnezevic 3, Srbislav Knezevic 4, Biljana Milicic 5, Tomica Milosavljevic 2.

1 Faculty of Medicine, University of Belgrade, Belgrade, Serbia Clinic forGastroenterology, Clinical Center of Serbia, Belgrade, Serbia2 Faculty of Medicine, University of Belgrade, Belgrade, Serbia Clinic forGastroenterology, Clinical Center of Serbia, Belgrade, Serbia3 First Surgical Clinic, Clinical Center of Serbia, Belgrade, Serbia, Serbia4 Faculty of Medicine, University of Belgrade, Belgrade, Serbia FirstSurgical Clinic, Clinical Center of Serbia, Belgrade, Serbia, Serbia5 Institute for Medical Statistic and Informatics, School of Dentistry,University of Belgrade, Belgrade, Serbia, Serbia

Introduction: Chronic pancreatitis is a chronic inflammatory diseaseof the pancreas leading to exocrine and endocrine pancreatic insufficiency.Pancreatic cancer is a malignant neoplasm of the exocrine pancreas inwhich themortality rate is almost equal incidence of disease. The disease isdiagnosed at a late stage and the surgical treatment possible in only 10-15%of patients. Chronic pancreatitis and pancreatic cancer have complex andunclear aetiology and pathogenesis.

Aims: The aim of this study was to determine which characteristics ofpatients- age, gender, fat intake, smoking, alcohol consumption have thegreatest importance in the development of chronic pancreatitis andpancreatic cancer.

Patients & methods: The study included 55 patients with chronicpancreatitis, 45 patients with pancreatic cancer and 70 healthy controls.Multivariate regression analysis was used to identify predictive risk factorsfor pancreatic diseases.

Results: Results of our study showed that male, sex, older age, smok-ing, fatty diet were significantly higher in patients with pancreatic cancer.Women have five times lower risk for the occurrence of chronic pancre-atitis, and about four times lower risk for pancreatic cancer. With each yearof life the risk of pancreatic cancer is increased by 5%. Smokers were under3.5 times higher risk for pancreatic cancer.

Conclusion: In conclusion, these results suggest that pancreatic canceroccurs more frequently in older males and smoking is predictive risk factorfor pancreatic cancer.