Comparison of endoscopic retrograde cholangiopancreatography with papillary biopsy and endoscopic ultrasound-guided pancreatic biopsy in the diagnosis of autoimmune pancreatitis
| Autor: | Jong Kyun Lee, Kwang Hyuck Lee, Young Sik Woo, Sung Koo Lee, Jae Gu Jung, Woo Hyun Paik, Kyu Taek Lee, Do Hyun Park, Dong Wan Seo, Myung-Hwan Kim, Sang Soo Lee |
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| Rok vydání: | 2014 |
| Předmět: |
Endoscopic ultrasound
Adult Male medicine.medical_specialty Ampulla of Vater Endocrinology Diabetes and Metabolism Biopsy Sensitivity and Specificity Autoimmune Diseases medicine Humans Pancreatic biopsy Endoscopic Ultrasound-Guided Fine Needle Aspiration Pancreas Autoimmune pancreatitis Aged Retrospective Studies Cholangiopancreatography Endoscopic Retrograde Endoscopic retrograde cholangiopancreatography Hepatology medicine.diagnostic_test business.industry Gastroenterology Middle Aged medicine.disease digestive system diseases Endoscopy Pancreatitis Linear Models Female Radiology business |
| Zdroj: | Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]. 15(3) |
| ISSN: | 1424-3911 |
| Popis: | International consensus diagnostic criteria (ICDC) have been proposed for the diagnostic criteria and algorithm of autoimmune pancreatitis (AIP). Although endoscopy is important in the diagnosis of AIP, practical patterns of its usage vary considerably worldwide. This study aimed to compare endoscopic retrograde cholangiopancreatography (ERCP) with papillary biopsy and endoscopic ultrasound (EUS)-guided pancreatic biopsy for diagnosing AIP using ICDC.We retrospectively reviewed and classified 165 Korean patients diagnosed by Korean criteria from June 2007 to October 2013. Among them, 61 patients underwent ERCP with duodenal papillary biopsy (group A) and 62 patients underwent EUS-guided pancreatic biopsy (group B). We analyzed the diagnostic criteria and levels of each criterion, and type of AIP before and after endoscopic procedures.ERCP with papillary biopsy increased the diagnostic sensitivity from 65.6% (40/61) to 95.1% (58/61) (P0.01). EUS-guided pancreatic biopsy increased the diagnostic sensitivity from 50.0% (27/62) to 88.7% (55/62) (P0.01). The increases of diagnostic sensitivity in two endoscopic methods were not different statistically. In diagnosing definite AIP, EUS-guided pancreatic biopsy was more useful than ERCP with papilla biopsy (sensitivity; 79.0% vs. 65.6%, P0.01). EUS-guided pancreatic biopsy was helpful to classify type 1 and type 2 AIP in some patients. Procedure-related complication (mild pancreatitis) developed in one patient (1.6%) in group A and two patients (3.2%) in group B. ERCP with papillary biopsy was less expensive than EUS-guided pancreatic biopsy.Both ERCP with papillary biopsy and EUS-guided pancreatic biopsy are safe and play important roles in diagnosing AIP according to the ICDC. |
| Databáze: | OpenAIRE |
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