2.52% ± 0.30 respectively, p=0.01). Conclusions. Plasma and lymphatic GIP concentrations did not significantly change after DJE in Wistar rats. Bypassing duodenal K cells after duodenal exclusion is countered by an increase in mid-jejunal GIP intestinal content and secretion at the new site of primary nutrient absorption. This increase in intestinal GIP content likely explains the marginal and conflicting changes in plasma GIP concentrations after gastric bypass. M1762 Intestinal Preconditioning Causes Early Barrier Dysfunction Without Interfering with Ion Transport in Porcine Ileal Mucosa Fernando Huete-Toral, Elena Molina-Roldan, Iris Sanchez-Egido, Rocio Anula, Jesus A. Fernandez-Represa, Julio M. Mayol Background and Aim: The early protective effect of ischemic preconditioning (PC) on small bowel prior to harvesting and autotransplantation has been shown in animal models. However, little is known about the early impact of PC on intestinal ion transport and barrier function. The aim of this study was to investigate the early functional effects of intestinal PC on porcine ileal mucosa. Material and methods: After obtaining approval from our Animal Ethics Committee, six pigs were anesthetized using a standard protocol and the abdomen was approached through a midline laparotomy. Two contiguous 20-cm segments of small intestine proximal to the ileocecal valve were isolated. One of them was preconditioned by intermittent cross-clamping of the mesentery over 4 cycles of 5-minute ischemia and 10- minute reperfusion whereas the other served as control. Samples were obtained from both segments, immersed in iced-cold buffer and, subsequently, the stripped mucosa was mounted in modified Ussing chambers. Baseline and stimulated transepithelial resistance (TER in Ω x cm2) and short circuit current (Isc in μA x cm-2) were monitored with a dual clamp. Barrier function was investigated with spectrofluoretry using FITC as a probe. H&E staining was used to assess microscopic morphology. Student's t test was used for statistical analysis. Results: Preconditioning did not alter either baseline electrical barrier properties (TER: 78 ± 5.1 vs 72.9 ± 8.2; n=13, NS) or baseline currents (Isc: 30.9 ± 2.9 vs. 39.5 ± 7.5; n= 13,NS). Cyclic nucleotide-activated currents (peak Isc: 47.7 ± 3.4 vs 41.9 ± 2.5 ) or calcium- stimulated secretion (peak Isc: 5.5 ± 2.6 vs 6.2 ± 2.7) were not affected either. However, paracellular permeability assessed by FITC (Fluorescence at 30 min: 222 ± 61.7 counts vs. 65.3 ± 23.0 counts; n=6 p=0.038), was transiently increased. No morphological difference between preconditioned and control mucosa was observed (Figure 1) Conclusions: Intestinal PC does not alter either baseline or stimulated secretion but causes an early increase in permeability in porcine ileal mucosa. M1763 EGF-Receptor Targeting in Combination with Chemotherapy: Not Effective in Experimental Gastric Cancer Birgit Hotz, Elisabeth Schellhaas, Heinz J. Buhr, Hubert G. Hotz Background: Overexpression of epidermal growth factor receptor 1 (EGFR1) plays a central role in malignant transformation and tumor progression. EGFR1 inhibition by specific antibodies or tyrosine-kinase inhibitors yielded therapeutic effects in colon and lung cancer. Aim of this study was to evaluate the effect of EGFR1 inhibition alone or in combination with chemotherapy on human gastric cancer cell lines In Vitro and in an orthotopic nude mouse model. Methods: In Vitro: 3 human gastric cancer cell lines (poorly differentiated MKN-45 and AGS; well differentiated NCI-N87) were exposed to increasing concentrations of the chemotherapeutics Carboplatin (0 - 3000 μg/ml), Irinotecan (0 - 1000 μg/ml), Docet- axel (0 - 300 μg/ml), or to the EGFR1-antibody Cetuximab (0 - 100 μg/ml) and the EGFR- tyrosine-kinase inhibitor Erlotinib (0 - 10 μM). Cell proliferation was assessed after 24 hours by MTT-assay. In Vivo: 1 cmm fragments from subcutaneous MKN-45 donor tumors were orthotopically implanted into the gastric corpus of 48 nude mice. Animals were randomized in control and 3 treatment groups: the application of Carboplatin (20 mg/kg, weekly ip.), Cetuximab (1 mg, weekly ip.) or the combination of both substances started 4 weeks after tumor induction and was continued for 14 weeks or until death. Primary tumor volume, local infiltration and metastatic spread (dissemination score) were determined at autopsy. H&E stained sections of all organs were analyzed to assess micrometastasis. Results: In Vitro: Carboplatin was most effective among the evaluated chemotherapeutics and significantly reduced proliferation of gastric cancer cells in a dose dependent manner (MKN-45: - 81 %; AGS: - 57 %; NCI-N87: - 67 %). High concentrations of the EGFR1 inhibitors Cetuximab and Erlotinib only reduced proliferation of MKN-45 cells (- 16 % and - 17 %, respectively). In Vivo: table. Conclusion: The evaluated chemotherapeutics reduce proliferation of human gastric cancer cell lines In Vitro, but not In Vivo: Carboplatin as the most potent drug did not exert an effect, at least in a therapeutic setting, which started 4 weeks after tumor induction. Activating K-Ras mutations downstream of the EGFR may be a possible explanation for lacking effects of the EGFR-inhibitors. In Vivo results (MKN-45 tumors): A-907 SSAT Abstracts M2088 A UK Perspective On Litigation Following Groin Hernia Repair Bilal Alkhaffaf, Bart Decadt BACKGROUND: Since 1995, litigation following surgical procedures has cost the National Health Service (NHS) over 1 billion GBP (1.5 billion USD). 75,000 groin hernia operations are performed annually in the UK. Despite it being the most commonly undertaken general surgical operation, no study has examined litigation claims in the UK following groin hernia repairs. We aimed to analyse the trends and relationships of litigation claims related to groin hernia surgery in an attempt to improve patient care. METHODS: Data from the NHS Litigation Authority of all claims made from 1995 was analysed. Cases were grouped accord- ing to type of repair, cause of claim, injury sustained and outcome of claim. RESULTS: In total 351 claims were made. By the end of 2007, 296 cases had been settled, of which 139 (47.0 per cent) were in favour of the claimant. The total cost to the NHS was 7.3m GBP (11.2m USD). Testicular injury and chronic pain was a feature in 40 per cent of all claims. Visceral and vascular injuries and injuries requiring corrective procedures were the only predictors of a successful claim (p=0.029 and p=0.001 respectively). Claims against visceral and major vessel injuries were more likely to be successful in laparoscopic than open repairs (p=0.019). Chronic pain resulted in the highest average payout of 84,000 GBP (129,000 USD) (Figure). CONCLUSION: Patients should be fully informed of the incidence of testicular injury and chronic pain during the consent process. Approaches minimising visceral and vascular injury particularly in laparoscopic repair should be adopted to reduce litigation and improve patient care. Top Five Litigation Payouts M2089 The Impact of Laparoscopic Approach for Splenectomy On Surgical Risk Factors Roger T. Lis, Gordon G. Wisbach, Ali Tavakkolizadeh Introduction: Although laparoscopy has become the preferred surgical procedure for elective splenectomies, the risk factors for increased post-operative complications are not well defined. We identified the risk factors for post-operative complications for laparoscopic (LS) and open splenectomies (OS), to assess the impact of laparoscopic approach. Methods: A retro- spective review of all patients that underwent an elective splenectomy for non-traumatic indications between 1/1/1997 to 1/1/2007 was performed. Patient demographics, operative time, spleen weight, length of stay (LOS), and inpatient morbidity and mortality were recorded. LS and OS were compared on an intention-to-treat basis, using t-tests. Logistic regression was used to identify independent risk factors for a complication, and the impact of the laparoscpic approach on these individual risk factors was assessed. Results: A total of 262 patients (184 OS, 78 LS) were identified, with an overall complication rate of 11%, and a mortality rate of 3%. The LS group was associated with a significant reduction in LOS, morbidity, and blood loss, but an increase in surgical time (Table 1). The conversion rate was 13%, with the splenic weight being higher in the converted cases against non- converted (487 g vs. 296 g, p<0.05). Using logistic regression on pooled complication data, age (p=.049) and BMI (p=.003) were identified as independent risk factors for post-operative complications, whereas splenic weight was not. The effect of laparoscopic approach was compared to open surgery for these established risk factors. BMI (p=0.004) remained inde- pendent risk factors for OS, but not for LS. Further analyzing the impact of BMI on surgical complications, malnutrition (BMI<18.5) was associated with the highest risk for surgical complications and LS had no beneficial effect. The MIS technique however reduced the complication rate for the normal weight group (23% for OS vs. 4% for LS, p<0.05). Conclusions: LS can decrease established risk factors for surgical complications and improve SSAT Abstracts