neoplasm. After 4 months of the last surgery, it’s free of disease, with oral treatment of DBT and requirement of pancreatic enzymes. Discussion: Clear cell adenocarcinoma of pancreas is a rare entity, little is known about its incidence and prognoses. Recently some publications talks about a renaissance of TP when it is indicated, nevertheless, others publications, shows an important impairment in quality of life after TP. Conclusion: Litle is known about clear cell adenocarcinoma of pancreas due to his low incidence, there are no gold standards for treat- ment. A spare pancreatic resection achieving an R0 margin, and trying to avoid an impairment in the quality of a total pancreatectomy was done in this patient, long term follow is still needed to conclude about its result. 0164. Interventional and diagnostic EUS in the management of pancreatic disease in child e a large single centre study Alecio Rampazzo-Neto 1 , Miguel Varca 1 , Renato Dal Col Paulino 1 , Rafael Kemp 2 , Jose Sebasti~ ao Dos Santos 2 , Jose Celso Ardengh 2 1 Endoscopic Service of Hospital 9 de Julho, Brazil 2 Ribeirao Preto Medical School, University of Sao Paulo, Brazil Introduction: EUS is useful for assessing disorders of the digestive system in adults because of its well established accuracy and safety. Aim: Our aims was to evaluate the diagnostic and interventional in- dications of EUS, its safety and impact on the clinical management of EUS- guided interventions in pediatric population with pancreatobiliary disorders. Background: The data on the diagnostic and therapeutic indications of the techinique remain scarce when dealing with pediatric patients. It hasn't well role determined and continues to evolve. Method: We performed a retrospective review all of our records of diagnostic and / or therapeutic EUS procedures of a single center in bil- iopancreatic diseases. From January 2010 until December 2016, 68 children (mean age: 15.9 years, range: 4-18 years) with suspicion of pan- creatobiliary disorders detected by clinical history and / or imaging tests were undergoing to diagnostic or therapeutic EUS. The most common indications was recurrent acute pancreatitis (20), pancreatic mass (16), abdominal pain with a suspicious of biliopancreatic cause (13), biliary obstruction (6), pancreatic trauma (2), acute necrotizing pancreatitis with infected WON (2), duodenal bulging (1), and elevation of CA19-9 (1). Results: EUS had positive impact on 48/68 (70%) patients. After obtaining a medical history and analysis of imaging tests 26/68 (38%) were indicated for ERCP, but the use of EUS before the ERCP avoided ERCP in 20/26 (77 %). EUS reoriented patients for surgical therapy in 33/68 (48%), and EUS- guided fine needle aspiration was performed in 23 patients with suspicion of pancreatic tumor (13), hypoglycemia (4), recurrent acute pancreatitis (3), abdominal pain (1), suspected biliary obstruction (1), enlargement of the pancreas (1). The sensitivity, specificity, positive, negative predictive value and accuracy of EUS-FNA for the diagnosis of malignant and benign lesions were: 88.2%, 83%, 93.8%, 71.4% and 87%, respectively. Discussion: Our study reports one of the largest series of diagnostic and / or therapeutic EUS in a pediatric population with pancreatic disor- ders, demonstrating the impact of diagnostic EUS and providing new in- formation and combined therapeutic applications between EUS and ERCP. Conclusion: It is therefore suggested to consider EUS as important diagnostic and therapeutic tool in the management of pediatric pancreatic diseases and avoiding the use of the diagnostic ERCP if we use rationaly EUS. 0168. Autoimmune pancreatitis type II: A case report E. Addo Yobo, Harika Balagoni, Chidinma Onweni, A. Patel, Jennifer Phemister, M. Srinath, Jennifer Treece, M.F. Young East Tennessee State University, United States Introduction: Autoimmune pancreatitis (AIP) is a group of rare het- erogeneous diseases including, IgG4related systemic disease, TypeI AIP and the less common, localized pancreatic disorder TypeII AIP. Aim: To discuss the rare TypeII AIP, clinical presentation and treatment recommendation. Background: We report a case of 64-year-old male who presented with acute pancreatitis. History and diagnostic workup were negative for the most common causes of pancreatitis. Laboratory studies were negative including ANA and IGG-subclasses. Magnetic-Resonance- Cholangiopancreatography (MRCP) showed dilated intrahepatic and extrahepatic bile ducts and a distal common bile duct (CBD) stricture with enlarged pancreatic head. Endoscopic-ultrasound (EUS) with fine needle aspiration (FNA) of the mass revealed IgG4-negative benign glandular cells with neutrophil infiltrate. A few days later, the patient reported newonset diarrhea. Colonoscopy with histological evaluation showed changes of indeterminate colitis. He was treated with corticosteroids with symp- tomatic improvement. A repeat EUS done 6-months later, was normal with no evidence of dilated CBD or pancreatic mass. This implies that the pancreatitis and colitis were responsive to steroids, pointing to an auto- immune cause, likely Autoimmune pancreatitis Type-II. Discussion: AIP is an immune-mediated disorder of unclear etiopa- thogenesis. Symptomatically, both types are indistinguishable. The most common symptom is abdominal pain followed by obstructive jaundice, weight loss. Type-I is associated with elevated levels of IgG4 Autoantibody, IgG4-positive cells and extra-pancreatic manifestations. Type-II is IgG4- negative with no extrapancreatic involvement except inflammatory bowel disease. Histologically, Type-I has lymphoplasmacytic sclerosing pancrea- titis (LPSP) whilst, granulocytic epithelial lesions (GEL) is specific to Type-II. Conclusion: Corticosteroid treatment resolves strictures of the extra- hepatic bile ducts and main pancreatic duct, as well as the pancreatic mass and retroperitoneal inflammatory pseudotumors. Although, difficult to diagnose, Type-II AIP is very sensitive to steroid treatment with fewer relapses compared to Type 1 AIP. 0169. Vasohibin 2 reduces chemosensitivity to gemcitabine in pancreatic cancer cells via JUN proto-oncogene dependent transactivation of ribonucleotide reductase regulatory subunit M2 Min Tu, Haifeng Li, Nan Lv, Chunhua Xi, Zipeng Lu, Jishu Wei, Wentao Gao, Yi Miao Pancreas Center, The First Affiliated Hospital of Nanjing Medical University, China Introduction: Pancreatic cancer carries a uniformly poor prognosis with low surgical resection rate and short survival time. Gemcitabine is the first-line chemotherapy drug for adjuvant treatment of pancreatic cancer, but has demonstrated limited ability to improve the prognosis of patients with pancreatic cancer. The poor efficacy of gemcitabine in pancreatic cancer is due to chemoresistance of the cancer cells. The mechanism of chemoresistance to gemcitabine is elusive, and it is necessary to define gemcitabine-resistance mechanisms in pancreatic cancer to identify novel targets and develop means to overcome chemoresistance to gemcitabine. Background: Vasohibin 2 (VASH2) has previously been identified as an agiogenenic factor and a cancer related protein. Here we investigated the association of VASH2 expression and chemoresistance in pancreatic cancer. Method: Immunohistochemical staining for VASH2 was performed on 102 human pancreatic cancer samples. Pancreatic cancer cell line models exhibiting overexpression or knockdown of VASH2 were generated. Gene expression analyses were carried out to determine genes differentially regulated by VASH2. Putative transcription factors that are downstream mediators of gene expression regulated by VASH2 were queried bio- informatically. Dual-luciferase reporter assays and ChIP assays were per- formed to confirm transactivation of target genes following VASH2 overexpression or knockdown. Results: VASH2 protein expression was higher in human pancreatic cancer than in paired adjacent tissues and elevated VASH2levels were Abstracts / Pancreatology 17 (2017) S1eS68 S35