Autoimmune Pancreatitis: A Critical Analysis of the Surgical Experience in an Era of Modern Diagnostics.
Adult
Aged
Aged, 80 and over
Antigens, Tumor-Associated, Carbohydrate
/ metabolism
Autoimmune Pancreatitis
/ diagnosis
Carcinoma, Pancreatic Ductal
/ diagnosis
Female
Humans
Immunoglobulin G
/ metabolism
Male
Middle Aged
Outcome Assessment, Health Care
Pancreas
/ immunology
Pancreatectomy
/ methods
Retrospective Studies
Tomography, X-Ray Computed
/ methods
Journal
Pancreas
ISSN: 1536-4828
Titre abrégé: Pancreas
Pays: United States
ID NLM: 8608542
Informations de publication
Date de publication:
01 04 2021
01 04 2021
Historique:
entrez:
3
5
2021
pubmed:
4
5
2021
medline:
20
1
2022
Statut:
ppublish
Résumé
The aim of this study was to critically analyze the surgical experience of managing autoimmune pancreatitis (AIP) in an era of modern diagnostics and compare these patients with those who were managed conservatively. Two prospectively maintained databases were used to retrospectively identify patients with AIP who were either managed conservatively or underwent pancreatectomy. Eighty-eight patients were included in the study, of which 56 (63.6%) underwent resection and 32 (36.4%) were managed conservatively. Patients who underwent resection were more likely to present with jaundice (64.3% vs 18.1%, P < 0.001) and weight loss (53.6% vs 15.6%, P = 0.005). The cohort who underwent resection had a significantly higher median carbohydrate antigen 19-9 (40.0 vs 18.6 U/mL, P = 0.034) and was less likely to have elevated immunoglobulin G4 (26.1% vs 50.0%, P < 0.001). The most frequent initial diagnosis in the cohort who underwent resection was ductal adenocarcinoma (82.1%). Nine patients (28.1%) in the conservatively managed cohort experienced AIP relapse compared with 6 patients (10.7%) in the cohort who underwent resection. The most frequent reason for surgical resection of AIP is concern for malignancy. Carbohydrate antigen 19-9 elevations were more common than immunoglobulin G4 in our cohort, suggesting that this laboratory profile is suboptimal for this population.
Identifiants
pubmed: 33939669
doi: 10.1097/MPA.0000000000001812
pii: 00006676-202104000-00012
doi:
Substances chimiques
Antigens, Tumor-Associated, Carbohydrate
0
Immunoglobulin G
0
carbohydrate antigen 199, human
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
556-563Informations de copyright
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
The authors declare no conflict of interest.
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