Conclusion: In conclusion,

we present a case of MANEC of the mid CBD. Most of the MANEC cases, including this case, might be initially diagnosed as cholangiocarcinoma. It is considered difficult to diagnose MANEC through biopsy via ERCP, because neuroendocrine component is embedded in the deeper portion of the tumor. So we suggest that acquisition of surgical specimen and thorough investigations to make a correct diagnosis is important to establish the treatment click here and estimate the prognosis in the extrahepatic bile duct cancer. Key Word(s): 1. neuroendocrine; 2. neoplasm; 3. Cholangiocarcinoma; 4. Common bile duct; Presenting Author: YONGHWAN KWON Additional Authors: CHANGMIN CHO, MINKYU JUNG Corresponding Author: Dabrafenib supplier YONGHWAN KWON Affiliations: Kyungpook national university hospital Objective: To determine the effectiveness of endoscopic pancreatic sphincterotomy (EPS) for the prevention of post endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) in high risk patients compared with endoscopic pancreatic duct stent placement after EPS. Methods: This present study was conducted a single-blind, multi-center, randomized controlled trial to compare the incidence of PEP between EPS and dislodgement of the stent (5.0 Fr*, 50 mm). We enrolled patients

who are needed ERCP procedure with normal pancreatic duct and defined difficult cannulation as PD injection of contrast 3 or more times, 5 or more times of catheter insertion of P duct, or pancreatic parenchymal acnaization. Patients were randomized to a PST group (n = 22) or to a stent group (n = 30). After ERCP, we checked the patient’s abdominal symptom, serum amylase and lipase after 6, 24 and 48 hour for PEP. Results: Of total 56 difficult cannulation cases, each one case in both

groups was excluded due to procedure failure. Finally, 24 cases in EPS group and 30 patients EPS and stent group were enrolled (Fig-1). The mean age (±standard deviation) was 63.88 ± 9.64 years in EPS group and 63.53 ± 13.55 years in EPS and stent group. The male: female ratio 15 : 9 in EST group and 15 : 15 in EST and stent group. The mean procedure time (minutes) was 17.75 ± 14.18 in EST group and 17.37 ± 10.65 in EST and stent group. There were no significant differences between groups with respect to age, gender, mean 上海皓元 procedure time or the purpose of ERCP intervention. The frequency of PEP in EST and EST and stent groups was 9.1% (2/22) and 10.0% (3/30). The severity of pancreatitis was two mild cases in each group and 1 severe case in EST and stent group. There was no statical difference comparing the incidence of PEP in both group (P = 0.607, Fisher’s exact test). The rate of hyperamylasemia were 37.5% (9/24) in EST group and 16.7% (5/30) in the EST and stent group (P = 0.098, χ2 test). There was no other complication after procedure in both groups (Table-1).