One early post- procedure-related complication occurred with cyst wall-separation selleck resulting in intra-peritoneal air leak, which was endoscopically sealed using a “bear-claw” clip and patient had unremarkable
recovery with antibiotic therapy alone. Conclusion: EUS-guided therapy for peri-pancreatic fluid collections is clinically successful in the majority of patients by endoscopic means alone, while adjunctive “conventional” therapy can be reserved for those with incomplete clinical response. Using large diameter stents with or without nasocystic drainage is most helpful for patients with complex collections. J BROOKER, G DICKSON Waikato Hospital Background: Early oesophageal neoplasia is seen in patients with Barrett’s oesophagus as well as squamous lesion. Cap-assisted ligation EMR provides tissue staging to assist in treatment decisions and may achieve curative treatment. Methods: Retrospective review of prospective database of patients referred of early oesophageal neoplastic lesions between April 2010–May 2014. Results: The 14 patients (mean age 68.5 yrs, range 53–81 yrs) with early stage disease (11 males, 78.6%) underwent EMR. Underlying Barrett’s oesophagus was present in 11/14 (78.6%) with 8 having a visible nodule. Prior biopsy showed high grade dysplasia (HGD) in 10 (91%)
and 1 (9%) suspected adenocarcinoma. Three patients had suspected squamous neoplasia. Resected pathology confirmed adenocarcinoma in 4 patients (1 T1a, 2 T1sm and 1 early T2), HGD in one and LGD in 6 patients. EMR of squamous lesions Selleck JQ1 showed 2 LGD and 1 papilloma. Adenocarcinoma patients underwent chemoradiation alone in 2, chemoradiation and surgery 1 and surgery 1 alone, respectively. Six patients with prior HGD underwent HALO ablation therapy to treat residual Barrett’s oesophagus. No adverse events were recorded related to EMR. Conclusion: Cap-assisted ligation EMR is safe to perform in patients with early oesophageal neoplasia. This allows better tissue
staging of neoplastic lesions to determine appropriate adjunctive therapy with curative intent. AYS TING,1 D CROAGH,1,2 S ALEXANDER,3,4 D DEVONSHIRE,1 MP SWAN1 1Department of Gastroenterology, Monash Health, Melbourne, VIC, Australia, 2Monash University, Melbourne, VIC, Australia, Loperamide 3Department of Gastroenterology, Barwon Health, Geelong, VIC, Australia, 4School of Medicine, Deakin University, Geelong, VIC, Australia Introduction: In the last two decades, there have been numerous advancements in technology and innovations that have impacted ERCP practice. Varying recommendations exist to guide this practice but adherence to these guidelines is currently unknown. This survey was conducted to assess how ERCP is currently performed in Australia and to guide future research into this area of interventional endoscopy.