Aims: Associating liver partition and portal vein ligation in staged hepatectomy (ALPPS) is an alternative to conven- tional portal vein embolization or -ligation (PVE/PVL). In patients with technically resectable liver tumors but insuf- ficient future liver remnant (FLR) some growth stimuli is needed. Initial experiences indicated that the complication rate and perioperative mortality following ALPPS excee- ded that of PVE/PVL. The aim of this study was to assess the initial safety and feasibility of ALPPS at three Scan- dinavian HPB centers. Methods: Thirty-six patients (2:1 male:female), median age 67 (22e80) years were operated during a 26 month period at three Scandinavian institutions. Colorectal liver metastases was the most common diagnosis followed by cholangiocarcinoma and HCC. The number of lesions varied from 1e20. None of the patients had underlying liver disease. Results: All patients completed the 2-stage procedure at a median of 8 days (7e15) following stage 1. Majority of the patients had extended right hemi-hepatectomies, wheras the remaining few had conventional right hemi-hepatectomies and atypical ALPPS. Median hospital stay after the second procedure was 9.5 days (2e50). No perioperative mortality was observed. Although complications were observed in majority of the cases, the highest grade according to Clavien-Dindo grading was 3b, seen in 3 patients (8%). Conclusions: ALPPS is an alternative to PVE/PVL in some patients. An acceptable complication rate can be obtained in selected patient cohort and the feasibility and rate of severe complications found in this cohort compares favorably to previously published results with PVE and two-stage hepatectomy. Early recurrences have been found following ALPPS, and our short and intermediate onco- logical results will be presented. Randomized controlled trials to define what patients may benefit from ALPPS are lacking. A multicenter Scandinavian trial, LIGRO (www.clinicaltrials.gov NCT02215577) has therefore been initiated and has been enrolling patients since May 2014. LIVER 0752 DIFFERENTIATION OF HEPATIC ADENOMA FROM FOCAL NODULAR HYPERPLASIA WITH PRIMOVIST MRI: VALIDATION OF DIAGNOSTIC CRITERIA M. Doyle 1 , J. S. Bagia 2 , J. Yeo 1 , A. Teixeira-Pinto 2 and S. Tran 1 1 St George Hospital; 2 University of Sydney, Australia Aims: To evaluate performance of MRI with PrimovistÒ (Bayer Healthcare, germany) (pMRI) in discriminating Hepatic Adenoma (HA) from Focal Nodular Hyperplasia (FNH) by retrospectively applying assessment criteria described by Grazioli [1] to our series of pMRI images. Methods: Our hepatobiliary surgical database was retro- spectively reviewed for patients with histologically- confirmed HA or FNH, who underwent pMRI prior to tissue sampling. 12 patients with a total of 13 lesions (7 FNH lesions, 6 HA lesions) were identified. Two inde- pendent readers performed qualitative and quantitative analysis on all pMRI Including Signal Intensity (SI) char- acteristics during dynamic and delayed phases, and SI nu- merical quantification allowing contrast enhancement ratio (CER), liver-to-lesion contrast (LLC) and SI ratios to be calculated. Results: 12 patients with 13 lesions were included. Ther were 11 females. 5 patients had HA, 6 patients had FNH and 1 patient had 2 lesions, with one HA and one FNH. Mean size of HA lesions was 3.2cm and FNH 6.4cm. No HA demonstrated a central scar while 57e71% of FNH had SI characteristics in keeping with a central scar. All FNH lesions were iso- to hyperintense on portal venous and delayed dynamic phase imaging, while only 2 HA (33%) were iso-hyperintense during delayed dynamic phase im- aging. 67e83% of HA were isointense during hepatobiliary phase imaging while only 14e29% of FNH were hypo- intense during similar image sequencing. The CER of HA in the arterial phase (mean 86.1% +/ 42%) was similar to FNH (mean 104% +/ 74.7%), while the LLC of HA during the hepatobiliary was more strongly negative (mean 0.70 +/ 0.69) than FNH (mean 0.08 +/ 0.85). Conclusions: pMRI continues to improve diagnostic ac- curacy between HA and FNH. This qualitative and quan- titative assessment method is potentially reproducible, however some variability occurred as expected with small numbers and no prior experience with this type of imaging analysis. LIVER 0760 SURGICAL OUTCOMES OF METABOLIC SYNDROME RELATED HCC: A COMPARATIVE STUDY WITH VIRAL AND ALCOHOLIC HCC A. Ruzzenente, M. De Angelis, S. Conci, F. Bagante, A. Valdegamberi, F. Bertuzzo, G. Mantovani, C. Iacono and A. Guglielmi University and Hospital Trust of Verona, Italy Aims: Up to 30% of HCC are not related to usual risk factors, the majority of these HCC are associated with non- alcoholic fatty liver disease (NAFLD), hepatic manifesta- tions of metabolic syndrome (MS). The purposes of the study were to analyse the clinical features, short-term and long-term outcomes of metabolic syndrome HCC (MS- HCC) compared to alcoholic and viral HCC. Methods: One hundred twenty-four consecutive patients with available etiology data underwent liver resection for HCC from January 2006 to December 2013 in a single HPB tertiary referral center. The clinical, pathological and sur- gical features, overall survival and disease-free survival data were analysed. Results: Among 124 patients with HCC, 26 patients (20.9%) had MS, 35 patients (28.2%) had alcohol consumption  60 g/die (alcohol-HCC) and 63 patients (50.9%) presented a HBV and/or HCV infection (viral- HCC). Patients with MS-HCC resulted oldest compare with alcohol and viral HCC with a mean age of 74.83, 70.01 and 68.35 years, respectively, p = 0.029. MS-HCC showed lower rate of underlying cirrhosis (32% vs. 68.6% in alcohol-HCC and 68.3% in viral-HCC, respectively, HPB 2016, 18 (S2), e685ee738 e730 E-AHPBA: Poster Abstracts