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Gastroenterology Research and Practice
Volume 2014 (2014), Article ID 253471, 6 pages
http://dx.doi.org/10.1155/2014/253471
Clinical Study

Should Steroid Therapy Be Necessarily Needed for Autoimmune Pancreatitis Patients with Lesion Resected due to Misdiagnosed or Suspected Malignancy?

1Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
2Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China

Received 26 September 2013; Revised 12 December 2013; Accepted 23 December 2013; Published 22 January 2014

Academic Editor: Stuart Sherman

Copyright © 2014 Wenchuan Wu et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

To explore whether steroid therapy should be needed for autoimmune pancreatitis patients after operation, eight AIP patients receiving operation were enrolled in this study from January 2007 to July 2013. All patients underwent liver function, CA19-9, and contrast-enhanced CT and/or MRI. Tests of IgG and IgG4 were performed in some patients. Tests of serum TB/DB, γ-GT, and γ-globulin were undergone during the perioperative period. Six cases receiving resection were pathologically confirmed as AIP patients and two were confirmed by intraoperative biopsy. For seven patients, TB/DB level was transiently elevated 1 day or 4 days after operation but dropped below preoperative levels or to normal levels 7 days after operation, and serum γ-GT level presented a downward trend. Serum γ-globulin level exhibited a downward trend among six AIP patients after resection, while an upward trend was found in another two AIP patients receiving internal drainage. Steroid therapy was not given to all six AIP patients until two of them showed new lines of evidence of residual or extrapancreatic AIP lesion after operation, while another two cases without resection received steroid medication. Steroid therapy might not be recommended unless there are new lines of evidence of residual extrapancreatic AIP lesions after resection.