Conclusion: ESP for ampullary tumors is effective and safe. It can be curative for most ampullary adenomas. ESP for localized adenocarcinoma may be potentially curative in >50% patients.

Key Word(s): 1. ampullary tumours; 2. endoscopic papillectomy Presenting Author: YOUNG OOK EUM Additional Authors: SANG EON JANG, BYEONG SEONG KO Corresponding Author: YOUNG OOK EUM Affiliations: Cheongju Saint Mary’s Hospital, Cheongju Saint Mary’s Hospital Objective: Cholecystocolonic fistulas are rare complications of gallstones with a variable clinical presentation. Cholecystocolonic fistulas are often asymptomatic and it is difficult to diagnose them preoperatively. Methods: A patient who complaint diarrehea for one month visited local clinic and underwent colonoscopy. During colonoscopy, an 1 cm sized polypoid lesion was noted on ascending colon. During suction the air to observe the lesion closely, the polypoid lesion was sucked up and a hole like perforation was appeared. OTX015 manufacturer The patient was transferred to our hospital suspected bowel perforation. Results: On the physical exam, there was no specific findings such as abdominal tenderness. On abdominal computed tomography, small air was noted in the gallbladder and several common bile duct stones and gallbladder stones. We did ERCP (endoscopic

retrograde cholangiopancreatography) and removed CBD stones. Then cholecystectomy with segmental colonic resection was done. Conclusion: On operation field, a cholecystocolonic fistula was noted. After the operation, MK0683 datasheet the diarrhea was stopped and the patient recovered completely. Key Word(s): 1. cholecystocolonic fistula Presenting Author: HISASHI HATANAKA Additional Authors: TOMONORI YANO, NORIKATSU NUMAO, KENSUKE YOKOYAMA, JUN USHIO, TAKESHI TOMIYAMA, KIICHI TAMADA, HIRONORI YAMAMOTO Corresponding Author: HISASHI HATANAKA Affiliations: Jichi Medical University,

Jichi Medical University, Jichi Medical University, Jichi Medical University, Jichi Medical University, Jichi Medical University, Jichi Medical University Objective: This study was undertaken 上海皓元医药股份有限公司 to evaluate the efficacy of indigo carmine (IC) method in identifying the afferent limb with Roux-en Y (RY) reconstruction during double-balloon ERCP (DBERCP). Methods: DBERCP was performed in 94 patients with RY reconstruction from February 2009 to October 2013 at Jichi Medical University Hospital. We investigated accuracy rate of IC method in total gastrectomy (TG) group and in non TG group. In the second portion of the duodenum or at the distal site of esophagojejunostomy, after inflation of a balloon at the tip of the endoscope, 50 ml of IC was injected into the lumen. At the RY site, we evaluated the inflow of IC into both limbs and identified the limb with less inflow as the afferent limb. When the limb with less inflow was confirmed as afferent limb, the case was classified as “correct group”. Insertion time in correct group was compared to that in incorrect group.