Open Access
Endosc Int Open 2016; 04(08): E912-E917
DOI: 10.1055/s-0042-111201
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Transpapillary biliary stenting is a risk factor for pancreatic stones in patients with autoimmune pancreatitis

Hiroyuki Matsubayashi
1   Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
,
Yoshihiro Kishida
1   Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
,
Tomohiro Iwai
1   Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
,
Katsuyuki Murai
1   Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
,
Masao Yoshida
1   Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
,
Kenichiro Imai
1   Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
,
Yusuke Yamamoto
2   Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, Shizuoka, Japan
,
Masataka Kikuyama
3   Division of Gastroenterology, Shizuoka General Hospital, Shizuoka, Japan
,
Hiroyuki Ono
1   Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
› Institutsangaben
Weitere Informationen

Publikationsverlauf

submitted26. August 2015

accepted after revision13. Juni 2016

Publikationsdatum:
08. August 2016 (online)

Preview

Background and study aim: Pancreatic stones occasionally develop in autoimmune pancreatitis (AIP), often worsen endocrine and exocrine functions, and occasionally cause pain attacks. However, the risks of pancreatic stones in AIP have been poorly studied. The aim of this study was to analyze the risk factors associated with pancreatic stone formation in cases of AIP.

Patients and methods: In total, 50 patients with AIP (39 males, 11 females; mean age 64.0 years), followed up for at least a year, were analyzed for their demographic and clinical findings and pancreatic stone occurrence.

Results: In total, 50 patients were followed up for an average of 59.7 (12 – 120) months, with steroid treatment in 44 patients (88 %); pancreatic stones occurred in 14 (28 %) patients after the diagnosis of AIP and endoscopic treatment was needed in one patient with pain attack. The pancreatic stones appeared only in patients with long follow-up period (P < 0.001, 83.9 months vs. 49.6 months), biliary stenting (odds ratio [OR]: 8.40, P = 0.010), relapse (OR: 6.20, P = 0.023), jaundice (OR: 5.40, P = 0.019), and swelling of the duodenal major papilla (OR: 4.67, P = 0.040). Biliary stenting was placed for an average of 9.9 months in 27 patients. Multivariate analysis revealed a significant association only with biliary stenting (P = 0.011). The stones appeared relatively earlier in patients with stones in the main pancreatic duct or Santorini duct (22.1 months) than in patients where pancreatic stones developed elsewhere (53.4 months) (P = 0.018).

Conclusions: The risk of pancreatic stone development should be taken into account when a biliary stent is placed in patients with AIP.