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Short-Term and Long-Term Outcomes for Patients with Autoimmune Pancreatitis After Pancreatectomy: A Multi-institutional Study
Authors:Clancy J. Clark  Vicente Morales-Oyarvide  Victor Zaydfudim  John Stauffer  Vikram Deshpande  Thomas C. Smyrk  Suresh T. Chari  Carlos Fernández-del Castillo  Michael B. Farnell
Affiliation:1. Department of General Surgery, Wake Forest Baptist Health, Medical Center Boulevard, Winston-Salem, NC, 27157, USA
2. Division of Gastrointestinal Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
3. Division of Gastroenterologic and General Surgery, Mayo Clinic, Rochester, MN, USA
4. Division of Gastroenterologic and General Surgery, Mayo Clinic, Jacksonville, FL, USA
5. Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
6. Division of Anatomic Pathology, Mayo Clinic, Rochester, MN, USA
7. Division of Gastroenterology, Mayo Clinic, Rochester, MN, USA
Abstract:

Background

Autoimmune pancreatitis (AIP) is a rare subtype of chronic pancreatitis that may mimic adenocarcinoma of the pancreas. The aim of this study was to evaluate the short-term and long-term outcomes of pancreatectomy for patients with AIP.

Methods

In this multi-institutional study, we identified all patients who underwent pancreatectomy for AIP from 1986 to 2011. AIP was confirmed by pathology review. Clinical presentation, operative details, and postoperative outcomes were analyzed.

Results

Seventy-four patients (median age, 60 years; 69 % male) with AIP underwent pancreatectomy. The main indication for operation was concern for malignancy (n?=?59, 80 %). No patients were found to have pancreatic adenocarcinoma on final pathology. Major complications occurred in ten (14 %) patients, with one perioperative death (1 %). Clinically relevant (grade B/C) pancreatic fistulae occurred in two patients. No patients required reoperation for AIP and 11 (17 %) patients developed recurrent AIP.

Conclusion

Although we do not advocate pancreatectomy for AIP, strong suspicion of malignancy may require an operation in selected patients. For patients with AIP, pancreatectomy resulted in few pancreatic fistulae, a low rate of re-intervention, and a 17 % recurrence rate.
Keywords:
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