Endoscopic evaluation of factors contributing to intrapancreatic biliary stricture in autoimmune pancreatitis

被引：51

作者：

Hirano, Kenji ^{[1
]}

Tada, Minoru ^{[1
]}

Isayama, Hiroyuki ^{[1
]}

Yamamoto, Keisuke ^{[1
]}

Mizuno, Suguru ^{[1
]}

Yagioka, Hiroshi ^{[1
]}

Yashima, Yoko ^{[1
]}

Sasaki, Takashi ^{[1
]}

Kogure, Hirofumi ^{[1
]}

Togawa, Osamu ^{[1
]}

Arizumi, Toshihiko ^{[1
]}

Matsubara, Saburo ^{[1
]}

Nakai, Yousuke ^{[1
]}

Sasahira, Naoki ^{[1
]}

Tsujino, Takeshi ^{[1
]}

Kawabe, Takao ^{[1
]}

Omata, Masao ^{[1
]}

机构：

[1] Univ Tokyo, Dept Gastroenterol, Fac Med, Bunkyo Ku, Tokyo 1138655, Japan

来源：

GASTROINTESTINAL ENDOSCOPY | 2010年 / 71卷 / 01期

关键词：

SCLEROSING CHOLANGITIS; DIAGNOSTIC-CRITERIA; INVOLVEMENT;

D O I：

10.1016/j.gie.2009.08.008

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

100201 [内科学];

摘要：

Background: Intrapancreatic bile duct stricture in autoimmune pancreatitis (AIP) is usually diagnosed as sclerosing cholangitis even if the stricture is limited to the intrapancreatic area. However, it is not known whether compression caused by pancreatic edema or biliary wall thickening causes such a biliary stricture. Objective: Our purpose was to clarify the factor that contributes to intrapancreatic biliary stricture in AIP: pancreatic head lesion or biliary wall thickening Design: Single-center retrospective study. Setting: This study was performed in a tertiary care academic medical center. Patients: Fifty-six patients with AIP were included. Main Outcome Measurements: The relationship between the presence of a pancreatic head lesion and intrapancreatic biliary stricture was examined. Ill addition, the relationship between the extent of the interapancreatic biliary stricture and the wall thickening was evaluated. Results: Among 44 patients with a pancreatic head lesion, 41 (93%) had intrapancreatic bile duct stricture Among 12 patients without a pancreatic head lesion, only, 2 had such a stricture (P <.0001). Intraductal US showed, average intrapancreatic biliary wall thickening with severe stricture of 2.7 +/- 1.0 mm, significantly thicker than that with mild stricture (19 +/- 0.35 mm; P = .0200). Limitations: Intraductal US was not performed in all patients. Conclusions: Both pancreatic edema and biliary Wall thickening influcenced intrapancreatic biliary stricture ill AIP. This type of stricture should he differentiated from extrapancreatic biliary stricture that may be caused by biliary Wall thickening only (Gastrointest Endose 20.1,0;71:85-90.)

引用

页码：85 / 90

页数：6

共 18 条

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