Sa1427 Duodeno-Jejunal Bypass Liner for the Treatment of Obesity and Type 2 Diabetes: 1-Year Treatment With 6-Months Post-Removal Follow-up

is a safe and effective treatment. However, some pancreatic abscesses are located far away from the stomach. Aim: To evaluate if percutaneous endoscopic therapy offers a safe and more effective alternative treatment for pancreatic abscess. Methods: A retrospective analysis of the clinical outcome of 5 consecutive patients treated with the percutaneous approach because the pancreatic abscesses were located away from the gastric wall. Patients were either unfit for surgery or refused surgical treatment. They received treatment with Carbapenems and Fluoroquinolones or other broad-spectrum antibiotics. Percutaneous drainage of the abscess was performed using abdominal ultrasound-guided or CT-guided puncture and placement of a 12Fr PTCD drainage tube into the abscess cavity. The tube was kept in place for 1 to 2 weeks to allow the percutaneous sinus track to form. The track was then dilated and a flexible endoscope (regular gastroscope, nasal endoscope or choledochoscope) was inserted via the sinus track into the abscess. Pus was suctioned through the biopsy channel and a basket was used to remove the necrotic tissue. A double lumen tube (or two tubes) was inserted over a guide wire into the abscess cavity to provide (irrigation and) drainage. Results: Pancreatic abscesses were successfully drained in all 5 patients thus avoiding emergency surgery. Subsequent surgery was not necessary in 4 patients during a median follow-up of 7.6 months (range 5-12 months). Combined surgery and endoscopic therapy was performed in 1 patient because the necrotic tissue could not be removed completely with endoscopy. There were no complications. Conclusion: Preliminary study showed that debridement of pancreatic abscess with percutaneous flexible endoscopic therapy was feasible and safe. Further work is in progress. Figure 1 A Abdominal wall puncture B Gastroscope inserted into the abscess C Necrotic tissue in abscess cavity D The abscess after debridement Figure2 A X-ray view of endoscope in abscess B Removed necrotic tissue C Double lumen-tube drainage D Postoperative CT scan.