2024-03-29T14:15:28Z
https://soar-ir.repo.nii.ac.jp/oai
oai:soar-ir.repo.nii.ac.jp:00003675
2022-12-14T04:20:21Z
461:462
Mechanisms of Lower Bile Duct Stricture in Autoimmune Pancreatitis
Watanabe, Takayuki
Maruyama, Masahiro
Ito, Tetsuya
Maruyama, Masafumi
Muraki, Takashi
Hamano, Hideaki
Arakura, Norikazu
Hasebe, Osamu
Kawa, Shigeyuki
autoimmune pancreatitis
IgG4
IgG4-related sclerosing cholangitis
IgG4-related disease
Objectives We attempted to clarify the mechanism underlying lower bile duct stricture in autoimmune pancreatitis. Methods Imaging and histologic finding of the bile duct were assessed for 73 patients with autoimmune pancreatitis to clarify whether IgG4-related biliary inflammation or pancreatic head swelling is associated with lower bile duct stricture. Results Lower bile duct stricture was found in 59 (81%) patients. Pancreatic head swelling was significantly more frequent among patients with lower bile duct stricture than those patients without lower bile duct stricture (53 [90%] vs 4 [29%]; P < 0.01). Intraductal ultrasonography findings revealed lower bile duct wall thickening in 21 (95%) of the 22 patients with lower bile duct stricture, and the lower bile duct wall of the patients with pancreatic head swelling was significantly thicker than those patients without pancreatic head swelling (P = 0.028). Among the 38 patients with lower bile duct biopsies, 14 (37%) exhibited abundant IgG4-bearing plasma cell infiltration. Among the patients with lower bile duct stricture, an IgG4-related inflammation seemed to exert a dominant effect under limited conditions, including concomitant middle bile duct stricture and neither pancreatic swelling nor pancreatic duct stricture in the head region. Conclusions Both pancreatic head swelling and IgG4-related biliary inflammation affect lower bile duct stricture, which may be included in IgG4-related sclerosing cholangitis. Pancreatic head swelling affects IgG4-related biliary wall thickening.
Article
PANCREAS. 43(2):255-260 (2014)
journal article
LIPPINCOTT WILLIAMS & WILKINS
2014-03
application/pdf
PANCREAS
2
43
255
260
0885-3177
AA10674276
https://soar-ir.repo.nii.ac.jp/record/3675/files/Mechanisms_Lower_Bile_Duct_Stricture.pdf
eng
24518505
https://pubmed.ncbi.nlm.nih.gov/24518505
10.1097/01.mpa.0000437323.52598.20
https://doi.org/10.1097/01.mpa.0000437323.52598.20
Copyright© 2014 Lippincott Williams and Wilkins / This is a non-final version of an article published in final form in PANCREAS. 43(2):255-260 (2014)