Sa1131 Comparison of Gastrojejunostomy and Enteral SEMS in Management of Malignant Gastric Outlet Obstruction- A Single Tertiary Care Cancer Center Experience

California from 2005 to 2012. Case identification was performed using a prospective internal cancer registry. Data was collected on patient demographics, cancer stage, histology, preoperative EUS and type of surgery performed. Patients with surgical bypass procedure or exploratory laparotomy without resection were considered as ‘upstaged' at the time of surgery. The impact of pre-operative EUS was evaluated by comparing frequency of upstaged cases among patients undergoing pre-operative EUS vs. cases that proceeded directly to surgery (Chisquare test). Results: We identified 656 patients with stage I to IIb pancreatic cancer (determined by cross sectional imaging) that were included in the final analysis. Among these patients, 311/656 (47%) underwent surgery (pancreaticoduodenectomy, distal pancreatectomy, surgical bypass or exploratory laparotomy). Of the patients that underwent surgery, 69/311 (22.2%) were upstaged at the time of operation and did not undergo resection. Preoperative EUS was performed in 272/656 (41%) of overall cases. There was no difference in the frequency of cases that were upstaged at the time of surgery based on preoperative EUS (with prior EUS 9% vs without prior EUS 11%, chi-square p=0.78. Conclusion: Upstaging at the time of surgery occurred in 22% of cases in this study of patients with potentially resectable pancreatic cancer based on cross-sectional imaging. Use of preoperative EUS did not impact the frequency of patients that were upstaged at the time of surgery. Preop EUS and Surgery in patients with Pancreatic Cancer