pancreatic cancer and the stent was removed “en bloc” with the surgical specimen. During follow-up from stenting to surgery (63 days), bleeding did not relapse. In one patient (7.7%) the stent migrated 4 days after stent insertion but no signs of re- bleeding were observed (definitive clinical success: 100%). Two patients (15.4%) presented a mild pancreatitis which did not require premature stent withdrawal. No cases of cholecystitis were registered among the 8 patients with gall-bladder. Conclusions: 1. Short-term stenting proves to be an effective alternative to achieve initial and definitive hemostasia in post-sphincterotomy bleeding, avoiding potential stent related late complications as stent occlusion and associated cholangitis. 2. The use of short stents is effective and reduces the risk of secondary cholecystitis. 3. Cost/effectiveness studies are needed before considering stenting as the first choice treatment. Mo1430 The Biodurability of Advanced Hydrophilic Coating for Plastic Stents in a Bile Flow Phantom and a Swine Bile Duct Dilation Model Chang-Il Kwon* 1 , Gwangil Kim 3 , Seok Jeong 2 , Don Haeng Lee 2 , Kwang Hyun Ko 1 , Ki-Baik Hahm 1 , Sung-Pyo Hong 1 1 Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, Korea (the Republic of); 2 Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea (the Republic of); 3 Department of Pathology, CHA Bundang Medical Center, CHA University, Seongnam, Korea (the Republic of) Background/Aims: In order to overcome short stent patency time of plastic stents due to biofilm formation, newly improved plastic stents have been developed. The aim of this study was to evaluate whether plastic stents with advanced hy- drophilic coating have longer patency and more improved biodurability. Materials and Methods: The bile flow phantom model containing various types of 10F plastic stents provided continuous circulation of fresh human bile. Various types of plastic stents were also inserted into the bile duct of 7 swine bile duct dilation models. We performed an analysis of the degree of luminal narrowing by microscopic examination, and inner surface examination by scanning electron microscopy (SEM) of the removed stents. Results: In an in vitro bile flow phan- tom, biofilm formation was rarely observed in all stents 4 weeks after bile expo- sure. After 8 weeks of bile exposure, the plastic stent with hydrophilic coating (PS+HC) showed less formation of biofilm and less luminal narrowing than the plastic stent without hydrophilic coating (PS-HC) (p !0.001). A total of 31 stents were inserted into the bile duct of 7 swine model, and 24 stents could be retrieved among them 8 weeks later. The polyethylene PS+HC had a tendency to form more biofilm and to make the lumen narrower than polyurethane PS+HC (pZ0.062). In SEM examination, the hydrophilic coating layer was sustained until 8 weeks. Conclusions: The PS+HC tended to form biofilm less frequently than PS- HC. Polyurethane seemed to be more patent and durable than polyethylene in hydrophilic coating techniques. Mo1431 The Use of Fully Covered Self Expandable Metallic Stent in ERCP Related Type-2 Perforations Bulent Odemis, Erkin Oztas*, Ufuk B. Kuzu, Erkan Parlak, Selcuk Disibeyaz, Serkan Torun, Ertugrul Kayacetin Gastroenterology, Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey Background and Objective: The conservative management of endoscopic retro- grade cholangiopancreatography (ERCP) related retroperitoneal duodenal per- forations (Type-2) involves cessation of oral feeding, parenteral hidration, use of wide-spectrum antibiotics, antiacid therapy and nasobiliary(NBD) or nasogastric drainage catheter placement simultaneously with ERCP. To date, there are no any other studies evaluating the use of fully covered self expandable metallic stent (SEMS) simultaneously with nasobiliary drainage (NBD) and the effect of it to the clinical course of the patients. Methods: Data of the patients diagnosed as ERCP related Type-2 perforation, between January 2007 and August 2014 in the our clinic were retrospectively analyzed. NBD group was consisted of the patients treated with conservative management. The patients treated with additional placement of fully covered SEMS to common bile duct were entitled as NBD and SEMS group. Results: There were 17 patients with ERCP related Type-2 perforation (9 in NBD group and 8 in NBD and SEMS Group). The mean age of the patients were 48.11Æ25.3 and 54.75Æ20.8 years, in NBD group and in NBD and SEMS group, respectively(pZ0.56). 66.6% in NBD and 75% in NBD and SEMS group, CBD stone was the indication for ERCP. Perforation related length of stay in hospital were 15.77Æ5.2 days in NBD group and 12Æ3.2 days in NBD and SEMS group (pZ0.09). There was statistically significant difference for pain requiring the use of non-steroidal or narcotic analgesics among groups, with 55.6% (nZ5) in NBD group while none in NBD and SEMS group (pZ0.017). Fever was deter- mined during follow-up in 50% (nZ4) and in 37.5% (nZ3) of patients in NBD group and in NBD and SEMS group respectively (pZ0.61). The mean white blood cell count of the patients in NBD group was 7.243Æ2.191 /mm 3 and 7.500Æ2.380/ mm 3 in NBD and SEMS group, before the procedure (pZ0.82). In NBD group, the percentage of patients with leucocytosis were 88.9%(nZ8), 66.7%(nZ6), 22.2%(nZ2) and 22.2%(nZ2) on the first, third, fifth and seventh days, respec- tively. In NBD and SEMS group, the percentage of patients with leucocytosis were 50%(nZ4), 37.5%(nZ3), 25%(nZ2) and 12.5%(nZ1) on the first, third, fifth and seventh days, respectively. The difference of the percentage of the patients with leucocytosis in the first day of the procedure was tended to be statistically sig- nificant (pZ0.07). There were no need for surgical intervention and neither mortality in both groups. Conclusions: Additional usage of SEMS to conservative management in patients with ERCP related Type-2 perforations, significantly decreased the pain during the follow-up period. Also the development of fever and leucocytosis was considerably reduced in patients treated with SEMS, but the difference just missed the level of significance probably due to the small sample size in the present study Figure 1a. The orifice of the perforation was seen at the lateral wall of the papilla secondary to sphicterotomy (white arrow), 1b: The view after the placement of fully covered self expandable metallic stent, 1c; The orifice was completely obliterated at the tenth day of the procedure after the displacement of both nasobiliary drainage catheter and self expand- able metallic stent (black arrow) Mo1432 Is There Need for More Randomized Controlled Trails to Evaluate the Role of Prophylactic Antibiotics Before ERCP? a Meta-Analysis of Randomized Controlled Trials. Bhupinder S. Romana* 1 , Sameer Siddique 1 , Harathi Yandrapu 2 , Prashanth Vennalaganti 2 , Sreekar Vennelaganti 2 , Rindi M. Uhlich 1 , Sravanthi Parasa 3 , Tarun Rai 3 , Vijay Kanakadandi 3 , Ajay Bansal 2 , Prateek Sharma 2,3 , Abhishek Choudhary 2 1 Gastroenterology, University of Missouri-Columbia, Columbia, MO; 2 Gastroenterology, Kansas City Veterans Affairs Medical Center, Kansas, MO; 3 University of Kansas School of Medicine, Kansas, KS Background: Infections following ERCP are a dreaded complication with increased morbidity and mortality in severe cases. Despite numerous small scale random- ized controlled trials over the last 3 decades, the outcomes and recommendations have varied. We conducted a meta-analysis to investigate the role of prophylactic antibiotics in reducing the risk of post- ERCP cholangitis and post-ERCP pancre- atitis. Methods: MEDLINE/PubMed, EMBASE, Cochrane Central Register of Controlled Trials and Database of Systematic Reviews, and recent abstracts from major conference proceedings were searched (November 2014). Randomized studies comparing prophylactic antibiotics vs. no antibiotics for all ERCP’s (diag- nostic and therapeutic) were included. Pooled estimates of post ERCP cholangitis, bacteremia, pancreatitis and mortality were analyzed by using odds ratio (OR). Random and fixed effects models were used as appropriate. Publication bias was assessed by funnel plots. Heterogeneity among studies was assessed by calculating I !+O2 !+O measure of inconsistency. Results: Ten randomized controlled trials with total of 1705 procedures met inclusion criteria. All trials were of adequate quality. All the trials had subjects undergoing both diagnostic and therapeutic ERCP. Indications varied but included significant numbers with obstructive jaun- dice due to stones or malignancy. Majority of the trials administered antibiotics for prophylaxis 30 minutes to 1 hour before the procedure. Differing antibiotics uti- lizing varying routes were used in these trials with six trials notably administering cephalosporins and two trials using piperacillin. Post ERCP cholangitis was noted in 3.8 % in the antibiotic group vs. 5.8% in placebo group. On pooled analysis, significantly low odds of post ERCP cholangitis and pancreatitis were noted in antibiotic group when compared to the placebo group (OR Z 0.63; CI: 0.40 - 0.98; p Z 0.04; I 2 Z 25%, OR Z 0.37; CI: 0.15 - 0.89; p Z 0.03; I 2 Z 0%) with no sig- nificant heterogeneity. A trend towards decrease in other infective complications with antibiotics was noted but did not reach statistical significance (OR Z 0.64; CI: 0.41 - 1.01; p Z 0.06; I 2 Z 3.7%). No significant effect was noted for mortality ((OR Z 1.02; CI: 0.33 - 3.19; p Z 0.97; I 2 Z 0%). Conclusion: Prophylactic antibiotic administration before ERCP decreases odds of cholangitis and pancreatitis. How- ever, future large size randomized controlled trials will need to investigate the role of antibiotic prophylaxis under different clinical scenarios, irrespective of resolu- tion of biliary obstruction. www.giejournal.org Volume 81, No. 5S : 2015 GASTROINTESTINAL ENDOSCOPY AB417 Abstracts