| セッション情報 | International Session3(消化器内視鏡学会・消化器病学会合同)IgG4-related disease and endoscopy |
|---|---|
| タイトル | 消IS3-2：Importance of endoscopic retrograde pancreatography in diagnosis of segmental/focal type 1 autoimmune pancreatitis. |
| 演者 | K. Sumimoto（The Third Department of Internal Medicine, Division of Gastroenterology and Hepatology, Kansai Medical University） |
| 共同演者 | K. Uchida（The Third Department of Internal Medicine, Division of Gastroenterology and Hepatology, Kansai Medical University）, K. Okazaki（The Third Department of Internal Medicine, Division of Gastroenterology and Hepatology, Kansai Medical University） |
| 抄録 | Background: In 2011, the International Association of Pancreatology proposed the International Consensus Diagnostic Criteria (ICDC). The differential diagnosis of segmental/focal type autoimmune pancreatitis (AIP) and pancreatic cancer using imaging findings is sometimes difficult. We studied diagnostic sensitivity between computed tomography (CT) and endoscopic retrograde pancreatography (ERP), and proposed a diagnostic algorithm for AIP. Methods: Thirty AIP patients and 30 pancreatic cancer patients were retrospectively studied. Pancreas imaging on CT and ERP were independently evaluated by 3 pancreatologists (5, 10, and 20 years of career experience). We compared diagnostic sensitivity between CT and ERP. Diagnostic sensitivities of endoscopic ultrasonography-guided fine-needle aspiration (EUS-FNA), cytology of pancreatic juice, brushing cytology of pancreatic duct, bile cytology and bile duct biopsy were also compared. Results: Diagnostic sensitivities of combination with CT and ERP in segmental/focal type AIP were significantly higher than single imaging (26% in CT (P < 0.01) or 35% in ERP (P < 0.05) vs 63% in CT+ERP), but not significantly different in the diffuse type. Diagnostic sensitivities of EUS-FNA, cytology of pancreatic juice, brushing cytology of pancreatic duct, bile cytology and bile duct biopsy were 100% (5/5), 56% (5/9), 100% (5/5), 73% (11/15), and 50% (8/16). Conclusions: The combination of ERP and CT is important to carry out differential diagnosis of pancreatic cancer and segmental/focal type AIP. |
| 索引用語 | Autoimmune pancreatitis, Endoscopic retrograde pancreatography |