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自身免疫性胰腺炎——手术失误?

Autoimmune pancreatitis – a surgical mistake?

作者信息

Havlůj L, Whitley A, Hajer J, Hráček T, Gürlich R

出版信息

Rozhl Chir. 2022 Winter;101(11):540-544. doi: 10.33699/PIS.2022.101.11.540-544.

Abstract

Autoimmune pancreatitis is a specific type of chronic pancreatitis. Its clinical manifestation mimics pancreatic cancer. A multidisciplinary approach is necessary to establish the correct diagnosis. Autoimmune pancreatitis can be diagnosed on the basis of symptomatology, imaging methods, endoscopy, serology and histopathological examination. There are two different forms of autoimmune pancreatitis – type 1 and type 2. Type 1 is lymphoplasmacytic sclerosing pancreatitis and type 2 is idiopathic centroductal sclerosing pancreatitis. The disease most often takes a chronic form with acute exacerbations. In this paper we present two case reports of patients operated on for suspected malignancy of the pancreas, who were subsequently diagnosed with autoimmune pancreatitis based on histopathological examination. The aim of this communication is to point out the diagnostic pitfalls of this disease. Surgical treatment is not considered as a standard therapeutic method according to the current guidelines.

摘要

自身免疫性胰腺炎是一种特殊类型的慢性胰腺炎。其临床表现类似于胰腺癌。需要采用多学科方法来确立正确的诊断。自身免疫性胰腺炎可根据症状、影像学方法、内镜检查、血清学及组织病理学检查进行诊断。自身免疫性胰腺炎有两种不同类型——1型和2型。1型为淋巴细胞浆细胞硬化性胰腺炎,2型为特发性中央导管硬化性胰腺炎。该病最常呈慢性形式并伴有急性加重。在本文中,我们展示了两例因疑似胰腺恶性肿瘤而接受手术的患者病例报告,这些患者随后经组织病理学检查被诊断为自身免疫性胰腺炎。本交流的目的是指出这种疾病的诊断陷阱。根据当前指南,手术治疗不被视为标准治疗方法。

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