51 Methods: We describe the clinical features and high resolution impedance manometry(HRiM) results of 3 patients with liver transplantation who devel- oped CIDP. Two patients had orthotopic liver transplantation and the other had living-donor liver transplantation. Results: All 3 patients developed muscle weakness, dysphagia and body weight loss in the period of tapering immune suppressants. Diagnosis of CIDP were checked by neurologist consultation. All patients had immunosuppressive therapy with tacrolimus. Prednisolone in two cases and everolimus in one case were noted. Telbivudine treatment for chronic hepatitis B were given in all 3 patients. After HRiM evaluation, decreased functional oral intake scale(FOIS), distal contractile integral(DCI) and complete bolus rate were discovered. Plasma exchange were done and the follow up HRiM result showed obvious improved FOIS and DCI. Conclusion: HRiM is a feasible and effective tool for evaluation of dysphagia in CIDP patients. This exam can be utilized before and after proper treatment. Disclosure: All authors have declared no conficts of interest. PS01.005: HIGH-RESOLUTION MANOMETRY GUIDING SURGICAL PROCEDURE FOR TREATMENT OF ACHALASIA OF THE ESOPH- AGUS. LONG-TERM RESULTS OF A PROSPECTIVE STUDY Tania Triantafyllou 1 , Georgia Doulami 2 , Charalampos Theodoropoulos 2 , Georgios Zografos 2 , Dimitrios Theodorou 1 1 Hippocration General Hospital of Athens, University of Athens, Athens/GREECE, 2 University of Athens, Athens/GREECE Background: Laparoscopic myotomy and fundoplication for the treatment of achalasia presents with 90% success rate. The intraoperative use of manom- etry during surgery has been previously introduced to improve the out- come. Recently, we presented our pilot study proposing the use of the HRM during surgery. The aim of this study is to evaluate the long-term outcome of the intraoperative use of High-Resolution Manometry (HRM) in achalasia patients. Methods: In this prospective study, consecutive achalasia patients underwent laparoscopic myotomy and fundoplication along with real-time use of HRM. Eckardt scores (ES) and HRM results were collected before and after surgery. Results: Twenty-three achalasia patients (22% Type I, 57% Type II, 22% Type III, according to Chicago Classifcation v3.0) with a mean age 48 years underwent calibrated and uneventful myotomy and fundoplication. Eleven myotomies were further extended, while sixteen fundoplications were intraop- eratively modifed, according to manometric fndings. During postoperative follow-up, mean resting and residual pressures of the LES were signifcantly decreased after surgery (16,1 vs. 41,9, P = 0 and 9 vs. 28,7, P = 0, respectively). The ES was also diminished (1 vs. 7, P = 0). Conclusion: The intraoperative use of HRM during laparoscopic myotomy and fundoplication for the treatment of achalasia of the esophagus is a safe, promising and effcient approach aiming to individualize both myotomy and fundoplication for each achalasia patient. Disclosure: All authors have declared no conficts of interest. Keywords: intraoperative manometry, fundoplication, achalasia, High Reso- lution Manometry PS01.006: ROLE OF HIGH RESOLUSION MANOMETRY FOR DIAG- NOSIS OF ESOPHAGEAL SPASTIC DISORDERS Hisako Kameyama 1 , Tatsuhiro Masaoka 1 , Tsuyoshi Yamane 1 , Hiroya Takeuchi 2 , Hirofumi Kawakubo 3 , Hidekazu Suzuki 3 , Yuko Kitagawa 3 , Takanori Kanai 1 1 Keio University school of medicine, Tokyo/JAPAN, 2 Hamamatsu University School of Medicine, Shizuoka/JAPAN, 3 Keio University School of Medicine, Tokyo/JAPAN Background: Esophageal spastic disorders such as spastic (Type III) acha- lasia, distal esophageal spasm, and Jackhammer esophagus are rare clinical condition. Moreover, symptoms associated with esophageal spastic disorders such as dysphagia, chest pain, regurgitation, and heartburn is not specifc to esophageal spastic disorders (Gastroenterol Clin North Am. 42:27–43, 2013.). Therefore, it is diffcult to diagnose esophageal spastic disorders from symp- toms. The aim of this study is to clarify diagnostic strategy for esophageal spastic disorders. Methods: Patients who underwent all of esophagogastroduodenoscopy (EGD), High resolution manometry (HRM: Starlet R )) and esophagography in our Hospital for evaluation of symptoms such as dysphagia, chest pain, regurgitation, and heartburn from November 2013 to November 2017 were involved in the study. After approval by the research ethical committee (No.20150081), we retrospectively reviewed the clinical fndings of these patients. Based on the Chicago classifcation (CC) v3.0 (Neurogastroenterol Motil. 27:160–174, 2015), fndings obtained by HRM were classifed. Patients who had past history of upper-gastrointestinal surgery were excluded from analysis. Results: 174 patients (Mean age of 58.6 ± 15.4; 70male) were fnally ana- lyzed. Based on fndings obtained by HRM, patients were classifed as 25 achalasia, 15 Jackhammer esophagus, 0 distal esophageal spasm, 25 Esoph- agogastric junction outfow obstruction, 25 weak peristalsis, 6 failed peri- stalsis, 78 normal. Moreover, 23 patients with achalasia were classifed as 8 Type I, 13 Type II, 4 Type III. In each subtype of achalasia, prevalence of esophageal dilation in EGD was 100%, 85%, 0%, respectively. In each subtype of achalasia, prevalence of liquid pool in esophagus in EGD was 100%, 69%, 0%, respectively. In esophagography, Compared with no fnd- ings group (15.5 ± 4.3cm), diameter of esophagus in patients with Type III achalasia(12.3 ± 4.8cm) were comparable, however that in patients with Type I(38.9 ± 18.6cm, P < 0.05) or Type II(32.0 ± 10.4cm, P < 0.01) achalasia were signifcantly wider. In patients with Jackhammer esophagus, prevalence of ring contractions in EGD and prevalence of corkscrew esophagus in esoph- agography were 33% and 13%, respectively. Conclusion: With only EGD and esophagography, it was diffcult to fnd vis- ible fndings which suggest esophageal spastic disorders. This suggests effcacy of HRM for diagnosis of this disorder and possibility of hidden esophageal spastic disorders in patients presumed as refractory GERD. Disclosure: All authors have declared no conficts of interest. Keywords: High Resolusion Manometry, Esophageal spastic disorders, acha- lasia, Jackhammer esophagus PS01.007: THE ROLE OF HIGH RESOLUTION MANOMETRY AFTER TOUPET-FUNDOPLICATION: COMPARING THE RESULTS WITH THE SYMPTOMS REMAINED 6 MONTHS AFTER SURGERY M´ at´ e Csucska , Bal´ azs Kov´ acs, Lilla Ozorai, ´ Arp´ ad Patai, Zolt´ an L´ oderer, ´ Arp´ ad Juh´ asz Markusovszky University Teaching Hospital, Szombathely/HUNGARY Background: Fundoplication is a well accepted method in treatment of gastro- esophageal refux disease. High Resolution Manometry (HRM) is essential in diagnosis of functional esophageal diseases. The aim of our study was to fnd the place and value of HRM after 6 months of Toupet-fundoplication, and fnd correlation in symptoms remained, if any. Methods: In 2016–2017 98 Toupet-fundoplications were performed by single surgeon. Surgeries were after HRM, EGD and pre-operative refux symptom questionnaire performed in our Esophageal Center. Six months after surgery EGD, HRM and post-operative symptom questionnaire was planned to manage in each patients. Results: Until Feb/01/2018 74/98 patients were more than 6 months after their operation. 72/74 patients completed the questionnaire and the EGD as well. 28/72 patients absolved HRM also. 25/28 patients had no complains and pre-operative symptoms relieved completely requiring neither PPI nor H2 blockers. 2/28 patients had gastric emptying problems, and 1/28 had mod- erate refux associated symptom. Compared to that 22/28 patients HRM ver- ifed abnormal values mostly in DCI, however these 22 patients were asymp- tomatic. It has to be mentioned that DCI was better pre-operatively than post-operatively in 12 out of 22 cases. Conclusion: Post-operative HRM can qualify and describe the wrap objec- tively (its location and basic pressure) however the latest Chicago-criteria was not developed for after-surgery states. We can conclude that post-operative routine HRM can mislead the physician, has importance only in patients with signifcant complains. Disclosure: All authors have declared no conficts of interest. Keywords: High Resolution Manometry, Toupet Fundoplication, Post- operative PS01.008: LOWER ESOPHAGEAL SPHINCTER PRESSURE (LESP) AS A MEASURE OF ANTI-REFLUX BARRIER IN PATIENTS WITH HIATUS HERNIA Balazs Kovacs 1 , Takahiro Masuda 2 , Ross Bremner 2 , Sumeet Mittal 2 1 St. Joseph’s Hospital and Medical Center, Phoenix/UNITED STATES OF AMERICA, 2 Creighton University School of, Phoenix/AZ/UNITED STATES OF AMERICA Background: Hiatus Hernia (HH), with its anatomical/physiological derange- ment of esophagogastric junction (EGJ) barrier function is a risk factor for pathological gastro-esophageal refux (GER). However, a subset of patients with HH do not have refux. The aim of this study is to explore Lower Esophageal sphincter parameters and GER across the EGJ in patients Downloaded from https://academic.oup.com/dote/article/31/Supplement_1/51/5097726 by guest on 10 September 2021