Electronic Poster Abstracts

secondary endpoints are predicting factors for tumor

recurrence and MJR.
Results: Among the 121 TACE patients, 106 (87.6%)
could be measured PR. The mean interval between TACE
and hepatic resection was 33.1 days. 5 year DFS rates by
PR status were as follows: 40.6% CPR, 43.7% MJR, and
49.0% MNR. There was also no signicant difference in
overall survival between 3 groups. Multivariate analyses
revealed that microvascular invasion and capsular invasion
(P = 0.001, hazard ratio [HR]: 13.7 and P = 0.031, HR: 2.3)
were independent predictors for DFS. Multivariate analysis
of the predictors of > 50% PR revealed that hepatitis B
antigen positive and capsular invasion were independent
factors.
Conclusions: These data could reect the PR after TACE
for resectable HCC may not be useful for predicting
recurrence of HCC after resection.

EP01E-025
IRINOTECAN-INDUCED NONALCOHOLIC STEATOHEPATITIS: THE
ROLE OF GUT BACTERIAL
TRANSLOCATION
M. L. V. Costa1, K. S. Arago2, R. C. P. Lima Jnior2,
J. W. B. d. Mesquita Neto3, G. A. d. C. Brito2,
M. H. L. P. d. Souza2, A. T. Melo4, H. A. Muniz5,
C. D. Lopes5, L. D. Prado5, C. B. M. Carvalho6,
P. R. C. d. Almeida2 and R. A. Ribeiro2
1
Dept. of Surgery, Division of Surgical Oncology,
2
Department of Physiology and Pharmacology, Faculdade
de Medicina, Universidade Federal do Cear, 3Department of Digestive Oncology, Institute of Cancer of Ceara,
4
Dept of Physiology and Pharmacology, 5Haroldo
Juaaba Hospital/ICC, and 6Center Medical Microbiology, Federal University of Cear, Brazil
Introduction: Postoperative liver failure is a major concern
after hepatic resection. Non-alcoholic steatohepatitis
(NASH) is a predictor of liver failure and can be induced by
the commonly used irinotecan-based chemotherapy regimens. The precise mechanism by which irinotecan (IRI)
leads to inammation and ultimately brosis is not
completely understood, therefore there is no effective
pharmacologic approach to prevent NASH. Recently, the
changes in gut microbiota and their association with the
expression of Toll-like receptors (TLR) ligands have been
advocated to play a major role in NASH. The purpose of
this study was to investigate whether there is a role for gut
bacterial translocation in the pathogenesis of IRI-induced
NASH.
Method: According to our previously published model,
IRI-induced NASH was induced by injecting swiss male
mice with saline (5 mL/kg, i.p.; control) or IRI (50 mg/
kg, i.p.) thrice a week for 7 weeks. Cultures of portal vein
and ocular plexus blood were performed and serum
concentrations of proteins, ALT and AST were
measured. Immunohistochemistry analysis for TLR-4,
IL-1, IL-18 and NOSi were performed in liver and duodenum tissues.
Results: In all mice that developed NASH and mucositis,
the cultures were positive for gram negative bacteria
(Escherichia coli) in both portal and orbital blood. It was
also demonstrated elevated imunostaining for TLR-4, IL-1

HPB 2016, 18 (S1), e1ee384

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and iNOS in both liver and duodenal samples. The cultures

were negative in all controls.
Conclusions: Translocation of gram-negative intestinal
bacteria, namely E. coli, leading to portal bacteremia may
represent the very rst hepatic insult of IRI-induced NASH.

EP01E-026
HIGH RISK GROUP OF HYDATID CYST
RUPTURE IN BILIARY TREE AND
SURGICAL IMPLICATION
H. O. El Malki1,2, A. Souadka1, A. Benkabbou1,
R. Mohsine1, A. M. Charif Chefchaouni1, L. Ifrine1,
R. Abouqal2 and A. Belkouchi1
1
Surgery Department A Ibn Sina Hospital, University
Mohammed Vth Rabat, and 2University Mohammed Vth
Rabat, Biostatical, Clinical Research and Epidemiological
Laboratory (LBRCE), Medical School, Morocco
Background and aims: Rupture through bile duct tree
occurred in Patients carrying liver hydatid cyst (LHC) and
developing biliocystic communication (BCC) have specic
clinic and therapeutic features. This situation occurred 15 to
40% of cases. Identifying high risk group of hydatid cyst
rupture in biliary tree allow an optimized therapeutics
strategies.
Methods: We identied patients from the operated patients
Registry of the surgery department A at Ibn Sina University Hospital, Rabat Morocco from 1990 to 2004. Fourteen risk factors for BCC occurrence were entered into
CART analysis to build an algorithm that can identify high
risk patients group with BCC.
Results: BCC was present in 24.5% of patients. Two
high risk Subgroups were dened: rst one where patients having jaundice associated to a thick pericyst, the
risk was 73.2%. The second subgroup containing patients
with thick pericyst, with no jaundice, 36.5 years-old and
younger with no past history of LHC, the risk was 40.5%.
Our developed CART model has sensitivity at 39.6%,
specicity at 93.3%, positive predictive value at 65.6%, a
negative predictive value at 82.6% and accuracy at
80.1%. Discriminating ability of the model was good
82%.
Conclusion: During a routine clinic visit of patient with
LHC (clinical history and ultasonography), physician
should draw attention to some factors as pericyst aspect,
jaundice, age, past history of liver hydatidosis and
morphological Gharbi cyst aspect. These factors could
construct a high risk group of BCC who can benet an
efcient orientation to the appropriate medical
structures.

EP01E-028
CURRENT DIAGNOSIS AND
MANAGEMENT OF COMPLEX
HEPATOBILIARY TRAUMA: THE ROLE
OF THE SUBSPECIALIST SURGEON
A. Greenbaum1, R. Miskimins1, M. Rojo2, I. Nir2 and
S. Lu1
1
Department of Surgery, and 2University of New Mexico,
United States