Data of post-surgery symptoms and quality of life (QoL) were collected and evaluated by all the investigators. Results In 228 patients with symptoms, the mean age was 49.39±12.33. Females are predominant with gender ratio at 1.4: 1 to males. The mean interval time between surgery and enrollment was 2.5±1.8 months (1.0 to 21.5 months). The total prevalence of abdominal symptoms after LC was 28.75% (228/793). The most common symptoms were diarrhea (129/793, 16.27%), abdominal pain (118/793, 14.88%) and bloat- ing (71/793, 8.95%). Nearly half of the patients (97/228, 42.54%) suffered from two or more symptoms. In patients with abdominal pain, the average score of Visual Analogue Scale (VAS) was 2.03±1.52 in total scale of 0 to 10. There were 11.02% patients with score above 4 (13/118) which defined as moderate to severe pain. Intermittent attack was occurred in majority of patients (112/118, 94.92%), with the frequency of 2.47±2.98 per week. A total of 97 patients (42.54%) complained about lower QoL, 16 of whom were rated as moderate to severe QoL influence. It's also relevant that among these 16 patients, the prevalence of abdominal pain was significantly higher than total population (14/16, 87.50% vs. 118/793, 14.88%, P<0.05). Despite the high ratio of patients with lower QoL, only 11.34% (11/97) patients got pharmacotherapy and the most commonly used drug was cholagogue (81.82%). Conclusions Abdominal symptoms frequently occur in post-LC patients. These symptoms significantly impair the patients' quality of life, especially for those who suffer from abdominal pain. Attention should be paid on the characteristics of post- LC symptoms. Standard diagnosis, treatment by different drugs and clinical outcome would be important in future development. An interventional study in the same population is being performed and further outcomes of treating post-LC abdominal pain with drug therapy will be reported. Mo1353 COMMON BILE DUCT STONE TREATED BY SIMULTANEOUS LAPAROSCOPIC AND ENDOSCOPIC RENDEZVOUS APPROACH DURING CHOLECYSTECTOMY: ANALYSIS OF 313 CONSECUTIVE PATIENTS Hugo Richter, Eduardo A. Vega, Carlos Harz, Sergio Fuenzalida, Enrique Waugh, Luis A. Montero, Max E. Buchheister, Hernan De La Fuente, Claudio Navarrete Background: Intraoperative endoscopic retrograde cholangiopancreatography (IO-ERCP) with laparoscopic rendezvous has been gaining wide acceptance among surgeons for the treatment of common bile duct stone (CBDS) associated to gallbladder disease. It provides a single-procedure solution and it seems to lower the rate of complications of ERCP because "over the wire" direct cannulation of the papilla. Patients and Method: This is a retrospective cohort study of 313 consecutive patients treated at a single center between 2008 and Sept 2016. Inclusion criteria were elective and emergency patients with cholelithiasis and simultaneous CBDS, diagnosed by ultrasound, MRI or intraoperative cholangiography (IOC). All were treated by laparoscopic cholecystectomy and IO-ERCP as needed. Results: We treated 313 patients (189 female), mean age 47.5 (16-90). A successful rendezvous and common bile duct (CBD) stone clearance was achieved in 297 (96%) of patients. The rate of conversion to open surgery was 1.3% (4 patients). The main complications of IO-ERCP were: post-sphincterotomy bleeding in 2 patients (0.6%) and mild acute pancreatitis in 1 patient (0.3%). The laparoscopic cholecystectomy complications were: hemoperitoneum in 1 patient, and one partial bile duct injury in another patient. There were no mortalities in this series. Mean procedure time was 85 min. Mean length of hospital stay was 2 days. Conclusion: IO-ERCP during cholecystectomy allows a high rate of CBDS clearance, a short hospital stay and low morbidity rate, in a single procedure for cholelithiasis and choledocholithiasis with no mortality. Mo1355 SURGICAL OUTCOMES AND PROGNOSTIC FACTORS IN PATIENTS WITH HILAR CHOLANGIOCARCINOMA' RADICAL RESECTION AND PREOPERATIVE BILIRUBIN LEVEL WERE INDEPENDENT PROGNOSTIC FACTORS OF TUMOR RECURRENCE AND OVERALL SURVIVAL RATE Xiangcheng Li Objectives Hilar cholangiocarcinoma (CC) is the most common CC, accounting for about 50% of all CC. Complete surgical resection remains the only hope for long-term survival in patients with hilar CC. The objective of the current study was to evaluate the outcomes of patients with hilar CC who underwent surgical resection and then to analyze factors influencing curative resection, tumor recurrence and overall survival. Methods From May, 2006 to April, 2015, 113 patients with hilar CC underwent surgical resection were retrospec- tively analyzed based on clinic characteristics, operative details, tumor recurrence and long- term survival data. Results 113 patients underwent curative resection and the rate of R0 resection was 70.8%. Combined liver resection was associated with significantly higher R0 rate than extrahepatic bile duct resection. Patients with Bismuth-Corlette type III and IV tumor had similar R0 resection rate with type I and II patients (70.0% and 73.9%, respectively). The overall 1-, 3-, and 5-year survival rates after resection were 76.1%, 37.2%, and 23% while the 1-, 3-, and 5-year tumor recurrence rates were 24.5%, 64.9%, 71.9%, respectively. Multivariate analysis showed that lymph node metastasis (P= 0.034), neural infiltration (P= 0.004), admission bilirubin level above 3.0 mg/dL (P= 0.043), positive resection margin (P= 0.001) and late stage (T3 and T4, P< 0.001) were independent prognostic factors on overall survival. Furthermore, admission bilirubin level (p=0.007) and resection margin (p=0.017) were selected as significantly factors affecting early hilar CC recurrence within one year after resection. Our further analysis showed that high bilirubin level was related with more lymph node metastasis and lower R0 resection. Furthermore, admission of bilirubin level was associated with postoperative complication and recovery of liver function. However, the preoperative biliary drainage did not affect overall survival after resection for hilar CC patients. Conclusion R0 resection and admission bilirubin level were independent prognostic factors on overall survival and early tumor recurrence after surgical resection for hilar CC patients. S-1275 SSAT Abstracts Mo1356 CARCINOMA GALLBLADDER IN ENDEMIC REGIONS HAS PROBLEM OF UNDER-DIAGNOSIS AND OVER-DIAGNOSIS Gautham Krishnamurthy, Sunil Shenvi, Rajesh Gupta, Naveen Kalra, Surinder Rana, Rajinder Singh Introduction High incidence of gallstone related benign diseases in endemic regions of carcinoma gallbladder, makes diagnosing malignancy difficult as many of them can have overlapping features. This is more important because in carcinoma gall bladder, preoperative tissue diagnosis is not recommended and for presumed uncomplicated gall stone disease transabdominal sonography is generally the only modality used for preoperative evaluation. Materials and methodology Present study is retrospective analysis of prospectively maintained data base between July 2002 and July 2016. All patients deemed resectable on clinical evaluation and CECT examination underwent surgical exploration. Patients of incidental carcinoma and those with benign histology after radical resection were the subject of present study. Results 127 patients with presumed diagnosis of resectable carcinoma gall bladder were included. One patient was diagnosed with hilar cholangiocarcinoma postoperatively and was excluded. There were 28 patients of incidental carcinoma gall bladder referred to us for completion radical cholecystectomy. These patients were termed as under-diagnosis. Preoperative USG reported gall stone disease with normal wall thickness in 17/28 patients. Detailed histopathology report of gall bladder specimen was available for 21 patients of which 13 had ≥T2 disease while 8 had T1 disease. Factors adversely affecting subsequent R0 resection in this group included presence of soft tissue mass in the gallbladder fossa, presence of comorbidities and nausea (p<0.05). There were 99 patients admitted with presumed carcinoma gall bladder. 23/99 had metastatic or unresectable disease on preopera- tive re-evaluation and 23 had inoperable disease on surgical exploration. 53 underwent radical surgery for clinico-radiological diagnosis of carcinoma GB. 10/53 had benign disease on histology. These included chronic cholecystitis (n=2), xanthogranulomatous cholecystitis (n=6) and gallbladder tuberculosis (n=2). This group represents over-diagnosis. On compar- ing the benign and malignant patients undergoing radical surgery, there was no difference in the preoperative clinical presentation (age, gender, pain, jaundice, cholangitis and abdominal findings) and preoperative CECT findings (Image 1,2). Conclusion 22% patients had inciden- tal carcinoma in the present series. High incidence of incidental carcinoma means that there is need for sensitization of sonologists to the possibility of carcinoma in gall stone disease especially in endemic regions. On the other hand, 19% had diagnosis of benign disease in patients undergoing radical cholecystectomy for presumed carcinoma. This high incidence impresses the need of better imaging techniques to make reliable differentiation between benign mimickers and malignancy to avoid morbidity of major resection. Contrast enhanced computed tomography showing xanthogranulomatous cholecystitis mim- icking carcinoma gallbladder with liver infiltration and possible duodenal involvement Contrast enhanced computed tomography of chronic cholecystitis showing irregular gall bladder wall thickening SSAT Abstracts