Conclusions: VFA measured at the umbilicus seems to be the best predictor for POPF. BMI, ASA III and the mean HU of the pancreatic body are independent predictors for severe complications following PD. A risk score to predict severe complications was developed. PANCREAS CANCER 0319 THE ROLE OF CT IN ASSESSMENT OF EXTRA-REGIONAL LYMPH NODE INVOLVEMENT IN PANCREATIC AND PERI-AMPULLARY CANCER: A PROSPECTIVE DIAGNOSTIC ACCURACY STUDY D. S. Tseng 1 , H. C. van Santvoort 1 , G. J. Offerhaus 1 , M. G. Besselink 2 , I. H. Borel Rinkes 1 , M. S. van Leeuwen 1 and I. Q. Molenaar 1 1 University Medical Center Utrecht; 2 Academic Medical Center Amsterdam, Netherlands Aims: Computed tomography (CT) is used to assess resectability of pancreatic and peri-ampullary cancer. One of the contra-indications for curative treatment is the presence of extra-regional lymph node metastases. Especially in the current era of neoadjuvant treatment accurate staging by CT is pivotal. We investigated the diagnostic accuracy of CT in assessing extra-regional lymph node metastases in pancreatic head and peri- ampullary cancer. Methods: This was a prospective observational cohort study in a tertiary HPB referral center according to the STARD guidelines for studies on diagnostic accuracy. We included patients undergoing pancreatoduodenectomy or palliative radiofrequency ablation (RFA) combined with bypass surgery. Extra-regional lymph node involvement was defined as lymphadenopathy in the aortocaval window. An expert HPB-radiologist prospectively assessed aorto- caval lymph nodes on preoperative CT according to a standardized protocol (i.e. short axis diameter, shape, cen- tral necrosis, irregular boundaries). All tissue from the aortocaval window was harvested intra-operatively. Posi- tive histopathology was the reference test. Results: Between March 2013 and December 2014, 77 consecutive patients with pancreatic head or peri-ampullary carcinoma were included. In 69 patients (90%) a pancrea- toduodenectomy was performed and 8 patients underwent RFA (n = 7) or only bypass (n = 1). A median of 3 aortocaval lymph nodes (IQR 1-4) were harvested per pa- tient. Nine patients (12%) had positive lymph nodes. Negative predictive value of CT in assessing aortocaval lymph nodes was 88% (95% CI 77e94%) and positive predictive value (PPV) was 10% (CI 1e46%). Overall diagnostic accuracy was 22%. Conclusions: CT has a low diagnostic accuracy in assessing extra-regional lymph node metastases in patients suspected of pancreatic or peri-ampullary cancer. This is mainly due to the high number of false positive results (i.e. poor PPV). Signs of aortocaval lymph node metastases on CT should therefore not be a contra-indication for surgical exploration or other treatments that are part of a strategy with curative intent. PANCREAS CANCER 0321 OUTCOMES FOLLOWING RESECTION OF METASTATIC DISEASE TO THE PANCREAS M. Pitchaimuthu, M. S. Khan, C. Coldham, J. Hodson, R. Marudanayagam, R. P. Sutcliffe, J. Isaac, P. Muiesan, D. F. Mirza and J. K. Roberts University Hospitals Birmingham NHS Foundation Trust, UK Aims: Metastases to the pancreas are rare and the outcomes after resection are unclear. The aim of this study is to evaluate mortality and survival associated with resection of metastases to the pancreas. Methods: Patients undergoing pancreatic resection for metastatic disease over a 16 year period (1997e2013) were identified from a prospectively maintained database. In- formation regarding the primary disease, nature of surgical resection, postoperative complications, pathological anal- ysis and adjuvant chemotherapy were collected. Follow up details including development and management of recur- rence and mortality were collected Results: 30 of 1438 pancreatic resections (2.1%) were for metastatic disease. The primary tumour was renal, colonic and melanoma in 23, 4 and 3 patients respectively. 13 pa- tients had pancreaticoduodenectomy, 6 patients had total pancreatectomy for multifocal disease, 9 patients had distal pancreatectomy and splenectomy. There were 5 (16.6%) postoperative mortalities (<90 days). 9 patients received adjuvant chemotherapy. At last follow up 12 patients were alive, 4 with disease and 13 had died, 12 with disease. The overall and disease specific survival at 1, 5, 10 years are 73, 47, 23% and 91, 43, 33% respectively. Excluding post operative deaths, the median survival was 35.6 (95% CI = 0.0 - 76.0) months. Conclusions: Both the duration of survival and proportion of patients alive at key time points compare favourably to patients undergoing resection for primary pancreatic or periampullary malignancy. Resection of metastatic tumours to the pancreas should be considered when possible. PANCREAS CANCER 0356 LAPAROSCOPIC LEFT PANCREATECTOMY IN A UK TERTIARY CENTRE; ANALYSIS OF A 5 YEAR EXPERIENCE N. G. Mowbray 1 , A. A. Al-Sarira 2 , A. Kambal 1 , T. H. Brown 1 and B. Al-Sarireh 1 1 Abertawe Bro Morgannwg University Health Board, UK; 2 Hashemite University, Jordan Aims: Minimal access surgery is becoming a standard approach to resect lesions in the tail and neck of the pancreas. The laparoscopic technique confers many ad- vantages over open surgery but there are few published case series of LLP from the UK. The aim of this study was to evaluate the results of performing Laparoscopic Left Pancreatectomy (LLP) for lesions in the neck and tail of the pancreas in a UK pancreatic centre. HPB 2016, 18 (S2), e747ee781 e758 E-AHPBA: Poster Abstracts