EUS-guided trucut biopsy in establishing autoimmune pancreatitis as the cause of obstructive jaundice
EUS-guided trucut biopsy in establishing autoimmune pancreatitis as the cause of obstructive jaundice
复制标题
DOI：
10.1016/s0016-5107(04)02802-0
复制
发表时间：
2005-03-01
影响因子：
7.7
通讯作者：
Petersen, BT
中科院分区：
文献类型：
--
作者：
Levy, MJ;Reddy, RP;Petersen, BT
背景：自身免疫性胰腺炎的诊断是困难的，通常需要比FNA单独提供的更大的标本来确定EUS结构活检（TCB）获得的组织样本是否足以进行足够的组织学检查以确定自身免疫性胰腺炎的诊断。方法：根据临床、实验室和影像学检查，对怀疑患有自身免疫性胰腺炎的梗阻性黄疸患者进行EUS TCB。对图表进行回顾性审查，以确定TCB的可行性。结果：2002年8月至2004年6月，3例梗阻性黄疸合并自身免疫性胰腺炎（AIP）患者行EUS TCB。在每个病例中，还考虑了胰腺癌的诊断，手术切除是患者接受EUS TCB之前的计划治疗。TCB标本的组织学检查确定了两例患者AIP的诊断，并确定了第三例患者慢性胰腺炎的非特异性变化。3例患者中有2例进行了eus引导下的FNA，但均未确诊。除1例轻微的暂时性腹痛外，未发现其他并发症。结论：本初步研究提示EUS TCB可以安全地建立AIP的诊断，有助于指导治疗，并有助于避免不必要的手术。需要前瞻性研究来验证这些发现，并更清楚地定义EUS TCB在这些患者中的作用。
Background: The diagnosis of autoimmune pancreatitis can he difficult and often requires a larger specimen than can be provided by FNA alone to determine if the tissue sample obtained with EUS trucut biopsy (TCB) is sufficient to allow adequate histologic review to establish the diagnosis of autoimmune pancreatitis.Methods: EUS TCB was performed in patients presenting with obstructive jaundice who were suspected of having autoimmune pancreatitis based on their clinical, laboratory and imaging studies. The charts were retrospectively reviewed to determine the feasibility of TCB.Results: Between August 2002 and June 2004, 3 patients with obstructive jaundice and suspected autoimmune pancreatitis (AIP) under-went EUS TCB. In each case, a diagnosis of pancreatic cancer also was considered, and surgical resection was the planned therapy before the patient underwent EUS TCB. Histologic review of the TCB specimens established the diagnosis of AIP in two patients and identified nonspecific changes of chronic pancreatitis in the third patient. EUS-guided FNA was performed in two of the 3 patients and failed to establish the diagnosis in either patient. Other than mild transient abdominal pain (n = 1), no complications were identified.Conclusions: This preliminary study suggests that EUS TCB can safely establish the diagnosis of AIP Doing so helps guide management and may help to avoid unnecessary surgery. Prospective studies are needed to verify these findings and to more clearly define the role of EUS TCB in these patients.