Clinical features and long-term prognosis of type 1 autoimmune pancreatitis based on the location of bile duct lesions.

IF 3.2 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Journal of Hepato‐Biliary‐Pancreatic Sciences Pub Date : 2025-04-14 DOI:10.1002/jhbp.12147

Takuya Ishikawa, Kentaro Yamao, Yasuyuki Mizutani, Tadashi Iida, Kota Uetsuki, Noriaki Gibo, Kunio Kataoka, Hiroshi Mori, Yoshihisa Takada, Hironori Aoi, Yoshiyuki Minami, Hiroki Kawashima

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Abstract

Background/purpose: Type 1 autoimmune pancreatitis (AIP) frequently involves biliary lesions and poses diagnostic and therapeutic challenges. We aimed to evaluate the clinical features and long-term prognosis of type 1 AIP with a focus on the locations of bile duct lesions.

Methods: In this retrospective study, 159 patients with type 1 AIP were included. Patients were classified on the basis of the location of bile duct strictures, and clinical outcomes, including relapse rates and steroid dependency, were analyzed.

Results: Eighty-nine (56%) patients had bile duct involvement. Forty-nine patients (30.8%) experienced relapse, with a significantly higher cumulative relapse rate in cases of stricture or wall thickening upstream of the intrapancreatic bile duct (3 years: 24% vs. 37.1%, p < .001). These patients also had a significantly higher rate of two or more relapses than did the patients without stricture or wall thickening (5.1% vs. 19.5%, p = .01). Two patients with stricture and dilation up to the intrahepatic bile ducts became steroid-dependent and were treated with azathioprine.

Conclusions: Patients with type 1 AIP with biliary lesions involving upstream strictures or wall thickening, especially those with stricture and dilation extending into the intrahepatic bile ducts, are at high risk of relapse and may become steroid dependent.

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基于胆管病变部位的1型自身免疫性胰腺炎临床特征及远期预后

背景/目的：1型自身免疫性胰腺炎（AIP）经常涉及胆道病变，给诊断和治疗带来挑战。我们的目的是评估1型AIP的临床特征和长期预后，重点是胆管病变的位置。方法：回顾性分析159例1型AIP患者。根据胆管狭窄的部位对患者进行分类，并对复发率和类固醇依赖等临床结果进行分析。结果：89例（56%）患者胆管受累。49例（30.8%）患者复发，胰内胆管上游狭窄或壁增厚的患者累积复发率明显高于胰内胆管上游（3年：24% vs. 37.1%）。结论：胆管病变累及上游狭窄或壁增厚的1型AIP患者复发风险高，特别是狭窄和扩张延伸至肝内胆管的患者，复发风险高，可能成为类固醇依赖。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Hepato‐Biliary‐Pancreatic Sciences GASTROENTEROLOGY & HEPATOLOGY-SURGERY

自引率

10.00%

发文量

178

审稿时长

6-12 weeks

期刊介绍： The Journal of Hepato-Biliary-Pancreatic Sciences (JHBPS) is the leading peer-reviewed journal in the field of hepato-biliary-pancreatic sciences. JHBPS publishes articles dealing with clinical research as well as translational research on all aspects of this field. Coverage includes Original Article, Review Article, Images of Interest, Rapid Communication and an announcement section. Letters to the Editor and comments on the journal’s policies or content are also included. JHBPS welcomes submissions from surgeons, physicians, endoscopists, radiologists, oncologists, and pathologists.