Aims: Aim of this study is the comparison of the incidence of PEP as a 8- hour or 24-hour infusion. Patients & methods: From February to August 2013, a total of 214 patients who underwent ERCP were analyzed. Patients were divided into 2 groups: 24-hour infusion with nafamostat mesilate (group A), 8-hour infusion (group B) (107 patients per arm). Serum amylase and lipase levels were checked before ERCP, 4 and 24 hours after ERCP, and when clinically indicated. The incidence of PEP was analyzed. Results: The overall incidence of acute pancreatitis was 5.6% (12/214). There was no significant difference in the incidence of PEP as 24-hour infusion or 8-hour infusion (6.6% vs 4.6% respectively; p ¼ 0.768). Also there was no significant difference in the incidence of hyperamylasemia (8.4% vs 6.5%, respectively; p ¼ 0.796). Conclusion: Since both nafamostat mesilate infusion protocols had equal incidence of PEP, 8-hour infusion of nafamostat mesilate is also helpful in preventing PEP. W-009. Early needle-knife or double-guidewire techniques for post-ERCP pan- creatitis in patients with unintentional repeated pancreatic cannulations Su Jin Kim, Daehwan Kang, Cheolwoong Choi, Hyung Wook Kim, Byeongjun Song, Su Bum Park Department of Internal Medicine, Pusan National University School of Medicine and Medical Research Institute, South Korea Background: Unintentional repeated pancreatic cannulation is one of several factors associated with post-ERCP pancreatitis (PEP). Recent studies reported that early use of needle-knife fistulotomy (NKF) is safe and effective. Double-guidewire technique (DGT) has also been reported to be useful for difficult biliary cannulation. Aims: The aims of this study were to compare PEP and success rates of early NKF and DGT to achieve biliary cannulation in patients with unin- tentional repeated pancreatic cannulations. Patients & methods: A total 1650 patients who underwent ERCP between January 2009 and December 2012 were included. 134 patients (8.1%) with unintentional repeated pancreatic cannulations more than 5 times within 5 min were assigned to early NKF or DGT. We placed a pan- creatic plastic stent when patients were considered as being high-risk PEP group. Results: Early NKF and DGT were tried in each 67 patients. Pancreas duct stents were inserted to 4, 5 patiens in early NKF and DGT groups, respectively. PEP was low in early NKF group (4.5%, 3/67) compared to DGT group (14.9%, 10/67, p ¼ 0.041). Pancreatitis severity was mild (n¼1), moderate (n¼2) in early NKF group and mild (n¼5), moderate (n¼5) in DGT group. No PEP occurred in patients with pancreatic stent. The success rates with early NKF and DGT were 79.1% (53/67) and 44.8% (30/67) (p < 0.001). Conclusion: Early NKF in patients with unintentional repeated pan- creatic cannulations showed lower PEP and higher success rate of selective biliary cannulation than DGT. Early NKF should be considered as the first approach in patients with unintended repeated pancreatic cannulations. W-010. Brush cytology yield in ERCP Filipe Vilas-Boas, Pedro Pereira, Armando Ribeiro, Jos e Sarmento, Marco Silva, Armando Peixoto, Susana Lopes, Guilherme Macedo Gastroenterology - Centro Hospitalar de S~ ao Jo~ ao, Porto, Portugal Background: Brush cytology during endoscopic retrograde chol- angiopancreatography (ERCP) remains the most feasible technique for obtaining samples from biliary and pancreatic strictures, since these lesions are not always readily accessible to biopsy. Aims: To report the diagnostic value of brush cytology for biliary and pancreatic strictures of unknown etiology. Patients & methods: We collected the data of all patients who underwent brush cytology of the bile duct, pancreatic duct and ampulla of Vater from January 2012 until December 2013. The specimens were eval- uated as cytoblock preparations and reported as inconclusive, negative for malignancy or malignant. The cytological diagnoses were correlated with the final diagnosis established by histopathology or clinical follow-up. Results: In all, 61 patients (median age 66±16 years; 62% male) had brush cytology (51 bile duct specimens/10 pancreatic duct specimens) and were included in the analysis. Twenty-seven specimens were diagnosed as benign, 21 as malignant, and 13 as inconclusive (yield 34.4%). Overall sensitivity was 62.5%, specificity was 96%, positive predictive value 95% and negative pre- dictive value 81%. On final diagnosis, strictures were benign in 23 patients, and malignant in 33 patients (19 pancreatic carcinoma, 8 cholangiocarcinoma, 6 ampullary carcinoma, 1 gallbladder carcinoma and 1 islet cell tumor). Conclusion: Our data shows that ductal brush cytology is a reliable technique with a very high specificity and modest sensitivity in the etiological diagnosis of pancreatobiliary lesions but sample interpretation with many specimens reported as inconclusive is an important limitation of its use W-011. Etomidate with meperidine for sedation during endoscopic retrograde cholangiopancreatography Byung Hyo Cha, Ban Seok Lee Digestive Disease Center and Department of Internal Medicine, Cheju Halla General Hospital, Jeju, Korea., South Korea Background: Endoscopic retrograde cholangiopancreaticography (ERCP) is a high-quality but invasive procedure. Aims: The aim of this study was to compare the efficacy and adverse effects of sedating patients undergoing ERCP with etomidate plus meper- idine (ETM) with those of midazolam plus meperidine (MDZ). Materials & methods: In the MDZ group, the initial dose of MDZ was 0.06 mg/kg, after which 1 mg was added intermittently during ERCP. In the ETM group, 0.1mg/kg ETM was initially injected, and an additional dose of 2 mg was added if needed. We analyzed the study patients’ vital signs including blood pressure, heart rate, respiration rate, oxygen saturation, and Ramsay sedation scales (RSS) during the preoperative, intraoperative, and recovery phases of ERCP. Additionally, the adverse effects of the sed- ative agents and those of the procedure were assessed and compared between the two groups. Results: Of 63 patients undergoing ERCP, 33 and 30 were randomly allocated to the MDZ and the ETM group, respectively. There was no stat- istical difference between the clinical baseline characteristics of both groups. In the ETM with MPD arm, the satisfaction scores of patients and the endoscopist were significantly higher (p ¼ 0.015 and p < 0.01, respectively), the intervention rates were significantly lower (number of intervention/ procedure time, p < 0.01), and there were fewer hypoxic events (p ¼ 0.013). Conclusion: We concluded that ETM in combination with MPD is superior to MDZ in combination with MPD for sedating patients during ERCP. Therefore, endoscopists can consider ETM with MPD as a good sed- ative regimen for therapeutic ERCP. W-012. Continuous infusion and intermittent bolus injection of propofol for deep sedation during endoscopic retrograde cholangiopancreatogra- phy (ERCP) Kyo-Sang Yoo, Youngouk Ro, Young Jae Byun, Sun Min Kim, Tae Yeob Kim, Chang Soo Eun, Joo Hyun Sohn, Yong Cheol Jeon, Dong Soo Han, Ho Soon Choi Hanyang Univ. Guri Hosp., Gastroenterology and Hepatology, South Korea Background: The propofol sedation method for deep sedation during ERCP is not established yet. Because of very short duration of propofol action, it is frequently more difficult to maintain constant level of sedation, required for the therapeutic ERCP, by intermittent bolus injection (IB) of propofol compared to continuous infusion (CI). Abstracts / Pancreatology 14 (2014) S1eS129 S24