| 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
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| タイトル |
消IS3-3：Weak points of ERCP dependent diagnosis for autoimmune pancreatitis
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| 演者 |
K. Hirano（Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo） |
| 共同演者 |
M. Tada（Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo）, K. Koike（Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo） |
| 抄録 |
Background: ERP finding is essential in Japanese diagnostic criteria for autoimmune pancreatitis (AIP). However, there seem some weak points.Patients and Methods: We analyzed 104 patients with AIP. The number of the patients in whom ERP finding was not obtained or useless for the diagnosis was clarified at first. Then, we examined their reasons and usefulness of EUS-FNA. The frequency of post-ERCP pancreatitis was also checked. Results: We could not depend on ERP finding in 17 (16%). Of these, EUS-FNA was performed in 6. Two patients rejected ERCP. Pancreatic cannulation was impossible in 4. In 11 patients, significant ERP finding was not obtained. Among them, in 3 patients with intrapancreatic pseudotumor-like AIP, there seemed no pancreatic ductal change indeed. In 8 patients, only pancreatic ductal disruption was observed. In 7 of them, the lesion was located mainly in the tail. EUS-FNA was useful for ruling out pancreatic cancer in all the cases, and showed supportive finding for AIP in 3 (50%). Post-ERCP pancreatitis was observed in 3 (2.9%). In 2 of them, the pancreatic lesion was limited to the tail.Conclusions: ERP is sometimes useless for the diagnosis in the patients with intrapancreatic psedotumor-like AIP or those with the lesion limited to the pancreatic tail. Moreover, the risk of post-ERCP pancreatitis might be high in them. EUS-FNA should be preceded in such cases if possible. |
| 索引用語 |
autoimmune pancreatitis, ERCP |
