Upper gastrointestinal lesions detected by magnetic-controlled capsule gastroscopy in patients with reflux or heartburn and asymptomatic individuals asymptomatic controls patients with heartburn or reflux p value total findings (%) 75 (44.6%) 91 (62.3%) 0.002 island of columnar epithelium in the distal esophagus (%) 3 (1.8%) 7 (4.8%) 0.130 erosive esophagitis (%) 6 (3.6%) 21 (14.4%) 0.001 bile in the stomach (%) 18 (10.7%) 19 (13.0%) 0.528 erosive gastritis (%) 25 (14.9%) 19 (13.0%) 0.634 gastric polyp (%) 14 (8.3%) 19 (13.0%) 0.177 gastric protuberance (%) 8 (4.8%) 3 (2.1%) 0.193 Gastric ulcer (%) 6 (3.6%) 4 (2.7%) 0.675 gastric tumor (%) 0 1 (0.7%) 0.465 small intestinal ulcer (%) 2 (1.2%) 8 (5.5%) 0.031 Tu1089 ENDOSCOPIC SUBMUCOSAL DISSECTION OF LARGE COLORECTAL TUMORS BY A ‘FLAP WITH CLIP METHOD’: SINGLE CENTER EXPERIENCE Hae Won Kim* 1 , Bong Min Ko 1 , Hyeonjeong Goong 1 , Yunho Jung 2 , Seong Ran Jeon 3 , Hyun Gun Kim 3 , Moon Sung Lee 1 1 Department of Internal Medicine, Digestive Disease Center Digestive Disease Center and Research Institute, SoonChunHyang Bucheon Hospital, Bucheon, Korea (the Republic of); 2 Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Cheonan, Cheonan, Korea (the Republic of); 3 Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Seoul, Seoul, Korea (the Republic of) Background: Endoscopic submucosal dissection (ESD) for colorectal tumor is tech- nically difficult because of the instability of the cutting area and poor visualization during the procedure. When the mucosal flap is formed after preliminary incision of the periphery of the lesion, the visual field of the submucosal layer on the cutting area is improved, which makes it easy to peel but it is difficult to create the mucosal flap. To overcome this disadvantage, we introduced a “flap with clip method”, which can effectively and safely perform ESD by forming a flap using a clip. Methods: A total of seven superficial colonic neoplasms (6 lateral spreading tumors, 1 subpe- dunculated polypoid tumor) was performed using a flap with clip method during colorectal ESD in our hospital. Therapeutic efficacy and safety were assessed. Results: The median size of the endoscopic lesions and resected histologic specimen was 37.8 mm and 34.8 mm. The median procedure time was 181 minutes. En bloc resection rates was 100% and no perforation and delayed bleeding was occurred. Intra-procedure bleeding event was treated with coagulation and complete hemo- stasis was done. Conclusions: A “flap with clip method” for colorectal ESD is considered to be safe and useful. This traction and exposure method could be helpful for creating novel flap during colorectal ESD and make ESD easier. Tu1090 HYPOALBUMINEMIA IS THE RISK FACTOR FOR MORTALITY AFTER PERCUTANEOUS ENDOSCOPIC GASTROTOMY PLACEMENT Kazunori Sugimura*, Sho Kawasaki, Masahiro Shinoda, Naoki Ishii Gastroenterology, Tokyo Shinagawa Hospital, Tokyo, Japan Background: Percutaneous endoscopic gastrostomy (PEG) has been widely used for nutrition support in patients with the inability to ingest orally. However, some pa- tients die at an early stage after PEG placement, and the risk factors of early mortality have not been sufficiently elucidated to date. The aim of this study was to evaluate the risk factors of mortality after PEG construction. Methods: This was a retro- spective cohort study in which 36 patients who had received PEG at Tokyo Shina- gawa Hospital from August 2014 to November 2018 were included. The primary outcome was death after PEG placement, which was measured as time-to-event variables. Age (80 or >80 years); sex; activity of daily living (ADL) rank; history of hypertension, heart disease, diabetes mellitus, cerebral vascular disease, neurode- generative disease, malignant tumor, or dialysis; and serum albumin (3 or <3 g/dl) and C-reactive protein (CRP) levels (<1 or 1 mg/dl) were examined as predictive factors. First, simple Cox regression analysis was performed in each predictor. Sec- ond, the predictors with P values of <0.1, namely age and sex, were included in the multivariate Cox proportional hazards regression model. Results: The cumulative incidence rates of mortality at 1, 3, and 10 months were 11%, 27%, and 49%, respectively. Male sex (p Z 0.078), history of neurodegenerative disease (P Z 0.076), and albumin level of <3g/dl (p Z 0.079) were judged to be significant factors in the simple Cox regression analysis. However, multivariate Cox regression analysis demonstrated that albumin level of <3 was a significant risk factor of mortality (hazard ratio, 4.32; 95% confidence interval, 1.07–17.5; p Z 0.04). Conclusion: Hypoalbuminemia was a significant risk factor of mortality after PEG placement, and attention should be paid in PEG placement for patients with malnutrition. Tu1091 EVALUATION OF LUMINAL STENTS IN THE MANAGEMENT OF MALIGNANT GASTROINTESTINAL STRICTURES Alyssa J. Meyer* 1 , Mahak Chauhan 2 , Zaheer H. Rizvi 1 , Prabh G. Singh 3 , Ikwinder P. Kaur 1 , Harangad S. Bhangoo 4 , Louis M. Wong Kee Song 1 , Navtej S. Buttar 1 1 Gastroenterology, Mayo clinic , Rochester, MN; 2 University of Missouri- Kansas, Kansas City, MO; 3 Physiology, Government Medical College and Hospital, Chandigarh, India; 4 Internal Medicine, Queens Hospital Center, Jamaica, NY Introduction: Endo luminal stents are being increasing used to palliate or prepare patient for successful definitive therapy. Our aim was to assess the durable symp- tom relief, need for re-intervention and complications related to stent use in the management of malignant gastrointestinal strictures. Method and Results: Between October 2009 and December 2016, a total of 465 patients (mean age 65.1 years [SD 14.7]; 54.8% male) with malignant stenosis of the gastrointestinal (GI) tract were treated with a stents. Out of 530 stents placed in these patients, predominant stents were uncovered WallFlex or Enteral wallstents (71.9%), Ultraflex (12.1%), or Evolution (7.0%) stents. 56.3% patient had proximal GI strictures. At 1- year post interventions 72.8% of malignant stenosis had durable symptom resolution with endoscopic stent placement. In 12.7% patients, stent provided a bridge to successful definitive surgery. 25.4% cases required reinter- vention after initial stent with 69.7% undergoing a stent placement on reinterven- tion. Complications occurred in 20.2% of all cases with the most common complication being reobstruction (12.7%) and stent migration (6.2%). Eight patients had acute gastrointestinal bleeding and four patients developed a fistula that could be attributed to the stent use. No patients died as a result of endoscopy. Lower GI defects were more likely to experience symptom resolution (hazard ratio [HR], 0.69; confidence interval [CI], [0.55-0.86]; pZ0.001). Having an older age per decade predicted poor symptom resolution (HR, 1.13; CI[1.05-1.22]; pZ0.001). Conclusion: Endoscopic management using stent(s) is a safe & effective option for symptom resolution and preparation for definitive surgical intervention for malignant gastro- intestinal strictures. www.giejournal.org Volume 89, No. 6S : 2019 GASTROINTESTINAL ENDOSCOPY AB551 Abstracts