Till final follow-up, BBS resolution without stenting was achieved in 4 patients. Intraductal RFA appears to be safe and effective for the management of BBS, however, randomized studies with longer follow-up are warranted. Key Word(s): 1. ERCP; 2. biliary

stricture; Presenting Author: NING CHEN Additional Authors: LIMING ZHANG, YULAN LIU Corresponding Author: YULAN LIU Affiliations: Peking University People’s Hospital Objective: Multiple primary malignant neoplasm had been reported occasionally, but cases which diagnosed at the early stage of the simultaneous carcinomas and been treated successfully by mini-traumatic therapies are rare. Here we report Alvelestat molecular weight such a case. Methods: A 64-year old male presented with recurrent epigastric discomfort for 6 months.

He had no past history of any other chronic diseases. Gastroscopy showed a 4 * 2 cm lesion with coarse plica mucosa at the antrum. Narrow Band Imaging (NBI), magnifying endoscopy and endoscopic ultrasonography indicated the lesion to be a early carcinoma, localized to mucosa. Histology of biopsies showed severe dysplasia and intramucosal carcinoma. Endoscopic submucosal dissection (ESD) was planned to perform and the patient was hospitalized. When undergoing routine examination, chest NVP-AUY922 nmr X ray found a possible malignant mass in the left upper lung and abdominal CT scan suspected carcinoma in gall bladder. Initially, mass in the lung had been suspected to be metastasis from stomach and if that was the case, ESD is contraindicated and surgery plus chemotherapy should be considered. But after careful discussion with thoracic surgeon and radiologist, mass in the lung was considered to be a primary neoplasm and should 上海皓元医药股份有限公司 be treated after ESD by thoracoscope, since thoracoscope may damage pulmonary function and delay the ESD. The mass in gall bladder was thought to be a individual neoplasm and laparoscopic cholecystectomy was recommended. Results: ESD was then

performed in the first step, followed by laparoscopic cholecystectomy, when histology showed Xanthogranulomatous Cholecystitis. 1 month later, biopsy during thoracoscope confirmed adenocarcinoma in the lung by frozen section and left upper lobe was resected. Conclusion: The patient had been followed up for 1 year and been well. Key Word(s): 1. gastric carcinoma; 2. ESD; Presenting Author: ZHI QUN LI Additional Authors: ENQIANG LINGHU, JIANGYUN MENG, HONGBIN WANG, XIANGDONG WANG Corresponding Author: ENQIANG LINGHU Affiliations: Department of Gastroenterology and Hepatology, the Chinese PLA General Hospital; Department of Gastroenterology and Hepatology, the PLA General Hospital Objective: Validate and improve the accuracy, feasibility of endoscope measurement ruler to measure the diameter of esophageal and gastric varices.