Short-Term and Long-Term Outcomes for Patients with Autoimmune Pancreatitis After Pancreatectomy: A Multi-institutional Study

Clancy J. Clark, Vicente Morales-Oyarvide, Victor Zaydfudim, John Stauffer, Vikram Deshpande, Thomas Christopher Smyrk, Suresh T Chari, Carlos Fernández-del Castillo, Michael B. Farnell

Research output: Contribution to journalArticle

9 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)899-906
Number of pages8
JournalJournal of Gastrointestinal Surgery
Volume17
Issue number5
DOIs
StatePublished - 2013

Fingerprint

Pancreatectomy
Pancreatitis
Pancreatic Fistula
Adenocarcinoma
Pathology
Chronic Pancreatitis
Reoperation
Pancreas
Neoplasms
Recurrence

Keywords

  • Adult
  • Autoimmune pancreatitis
  • Chronic pancreatitis
  • IgG4
  • Outcomes
  • Pancreatectomy
  • Surgery
  • Survival

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

Cite this

Clark, C. J., Morales-Oyarvide, V., Zaydfudim, V., Stauffer, J., Deshpande, V., Smyrk, T. C., ... Farnell, M. B. (2013). Short-Term and Long-Term Outcomes for Patients with Autoimmune Pancreatitis After Pancreatectomy: A Multi-institutional Study. Journal of Gastrointestinal Surgery, 17(5), 899-906. https://doi.org/10.1007/s11605-013-2145-1

Short-Term and Long-Term Outcomes for Patients with Autoimmune Pancreatitis After Pancreatectomy : A Multi-institutional Study. / Clark, Clancy J.; Morales-Oyarvide, Vicente; Zaydfudim, Victor; Stauffer, John; Deshpande, Vikram; Smyrk, Thomas Christopher; Chari, Suresh T; Fernández-del Castillo, Carlos; Farnell, Michael B.

In: Journal of Gastrointestinal Surgery, Vol. 17, No. 5, 2013, p. 899-906.

Research output: Contribution to journalArticle

Clark, CJ, Morales-Oyarvide, V, Zaydfudim, V, Stauffer, J, Deshpande, V, Smyrk, TC, Chari, ST, Fernández-del Castillo, C & Farnell, MB 2013, 'Short-Term and Long-Term Outcomes for Patients with Autoimmune Pancreatitis After Pancreatectomy: A Multi-institutional Study', Journal of Gastrointestinal Surgery, vol. 17, no. 5, pp. 899-906. https://doi.org/10.1007/s11605-013-2145-1
Clark, Clancy J. ; Morales-Oyarvide, Vicente ; Zaydfudim, Victor ; Stauffer, John ; Deshpande, Vikram ; Smyrk, Thomas Christopher ; Chari, Suresh T ; Fernández-del Castillo, Carlos ; Farnell, Michael B. / Short-Term and Long-Term Outcomes for Patients with Autoimmune Pancreatitis After Pancreatectomy : A Multi-institutional Study. In: Journal of Gastrointestinal Surgery. 2013 ; Vol. 17, No. 5. pp. 899-906.
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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.",
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