The diagnostic capability of the cytopathologist is greatly dependent on the MAPK inhibitor integrity of the cellular material provided for analysis. Aims: To compare concurrently the diagnostic efficacy (% of specimens considered adequate for
diagnosis by the cytopathologist) and diagnostic accuracy (compared to the final clinical diagnosis) of EUS-FNA specimens obtained from pancreatic solid tumors and GIST lesions using a liquid-based preparation, SurePath® (SP), and conventional smears with cell-block preparations (CSCB). Methods: Patients with a suspected solid pancreatic mass or GIST lesion referred for EUS and FNA were randomized to SP or CSCB for the first and third pass of the cytology needle. The alternate method was used for the second and fourth passes. The cytologist was not present during the biopsy and CSCB and SP specimens were sent to different laboratories. Results: Twenty seven patients were included in the pilot study. The cohort had a mean age of 68.6; 12 (44%) were female. Diagnosis of malignancy was made in 23/27 (85%) in the CSCB group, and 23/27 (85%) in the SP group. Malignancy was diagnosed on the 1st & 3rd passes alone in
0/27 (0%) patients, on 2nd & 4th pass alone in 4/27 (15%) patients, on both passes in 21/27 (78%) patients and on none of the passes in 2/27 (7%). Six patients had surgery: 5 had malignancy which AZD5363 solubility dmso were diagnosed by both SP and CSCB. Conclusion: In this pilot study, SP appears medchemexpress comparable to CSCB in the diagnosis of solid pancreatic mass and GIST lesions but SP has several distinct advantages:- 1) ease of use and storage of samples, 2) no requirement for cytology technician, 3) a large pellet of cells to assist diagnosis and 4), the ability to use immunochemistry to diagnose specific tumors (e.g, NET). A larger study is necessary to determine which technique has a higher diagnostic accuracy. E JOHNS,1 P WALSH1,2 1Department of Gastroenterology, Royal Brisbane and Women’s Hospital, Brisbane,
2Digestive Diseases Queensland, Holy Spirit Northside, Brisbane Introduction: Leaks complicate up to 5% of bariatric surgical operations and are a major cause of morbidity and mortality. Management is problematic with covered stents, clips and newer closure devices producing mixed results. These methods aim to exclude or close the defect to produce healing. 85% of leaks post sleeve gastrectomy occur in the proximal third of the stomach near the gastroesophageal junction. The aetiology is thought to be the elevated intraluminal pressure in this area caused by the reduced distensibility of the distal sleeve. This phenomenon may be a factor in roux-en-y pouch leaks due to narrowing of the gastrojejunostomy in the post-surgical period.