specific cutoff values for low MAI were chosen at below median value. Primary outcome was the rate of major (Clavien-Dindo ! 3) postoperative complications, secondary outcome was overall survival (OS). Results: In a total of 166 patients, median age was 66 years and 62.7% were male. Low SMI was present in 51.2% and low MAI in 49.4% of patients. After multivariate analysis, only low MAI (OR = 3.41, 1.17e6.80) was associated with major complications. After multivariate analysis, female gender (HR = 1.68, 1.09e2.56), lymph node ratio (HR = 16.72, 5.99e46.69), microscopic radicality (HR = 2.71, 1.73e4.23) and low MAI (HR = 1.67, 1.09e2.55) were significantly associated with decreased OS. Conclusion: Low muscle density, but not muscle mass, is associated with major complications and decreased OS after pancreatoduodenectomy for periampullary cancer. Future studies should differentiate between SMI and MAI and underlying mechanisms.

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choledocholithiasis. To clarify this lesion an echoendoscopy with puncture was performed e non-filing liquid; negative cytology for neoplastic cells and CEA of 8584 ng/ mL. The case was discussed in a multidisciplinary meeting and decided with surgery e performed a distal splenopancreatectomy, cholecystectomy, intraoperative cholangiography and transcystic exploration of the biliary tract without incidents. Histological examination showed a mucinous cystic neoplasm with low and intermediate grade degree dysplasia (without invasive carcinoma). Conclusion: Because at present we are unable to identify the benign mucinous cystic neoplasms that will progress into invasive carcinoma, all should be resected, regardless of size, in patients who are fit for surgery, because surgery is routinely curative in cases of non-invasive tumor.

IV-PCA was superior. Total opioid reduction and removal of the infusion pumps were achieved earlier in the IV-PCA group while opioid side-effects were more frequent in the EA group. Hospital stay was shorter in the IV-PCA group (median 74 vs 104h,p<0.001) Conclusion: Overall,IV-PCA demonstrated effective postoperative analgesia non-inferior to EA with a trend towards less side-effects and significantly shorter hospital length of stay.

patients will be enrolled. Secretin, ghrelin level will be checked on preoperative day, and 1,2,3,5,7 postoperative days. Preprandial gastric motility will be checked using electrogastrography at same time. Stomach transit time will be assessed using Radio-opaque Kolomark at preoperative day, and 3,7 postoperative days. Results: So far, 25 patients were enrolled. Among them, delayed gastric emptying was diagnosed in two patients. Electrogastrography showed reduced normogastria and stomach transit time was decreased at 3 postoperative days in normal patients. Conclusion: We will find relationship between gut hormone and gastric motility after enrolling more patients. Physiologic features of delayed gastric emptying will be observed. Finally, we hope to predict delayed gastric emptying before meals.