ROLE OF ENDOSCOPY AND DIAGNOSTIC METHOD IN AUTOIMMUNE PANCREATITIS

Abstract

There are two important modalities in the endoscopic diagnosis of autoimmune pancreatitis (AIP). One is endoscopic retrograde cholangiopancreatography (ERCP), which is useful in confirmation of the presence of characteristic irregular narrowing of the main pancreatic duct (MPD), and the other is endoscopic ultrasound fine needle aspiration and biopsy (EUS-FNAB), which enables histological diagnosis. Irregular narrowing of the MPD may be diffuse or localized, and it is sometimes recognized as multiple skip lesions. The presence of irregular narrowing of the MPD sometimes cannot be confirmed by ERCP when the pancreatic lesion is localized in the tail, and the MPD seems to be disrupted in such cases. The ability of EUS-FNAB in diagnosing AIP is still not sufficient, but it has shown dramatic improvement in the past several years due to the improvements in biopsy needles.