To refer a patient with diagnosed or suspected autoimmune or cholestatic liver disease, please contact the Autoimmune and Cholestatic Liver Clinic at 617-726-3313.
In order to determine the urgency of the appointment and to be certain the appropriate appointments are made, we ask that records be faxed to us at 617-724-6832 prior to scheduling the appointment. It is also critical that we receive the slides of all previous liver biopsies and a CD containing all previous radiologic studies, either before or on the day of the patient’s appointment. This will allow the patient to get the most out of his/her visit to the center.
Pancreatographic demonstration of narrowing of main pancreatic duct (MPD) forms essential criteria in diagnosis of AIP. In a study by Kamisawa et al. [ 23 ], obstruction of the MPD was detected more often in PC patients (60%) than in AIP patients (6%). The length of the narrowed portion of the MPD on endoscopic retrograde pancreatography (ERP) was ( ) cm in AIP patients, which was significantly longer than in PC patients ( ). The length of the narrowed portion of the MPD on ERP was longer than 3 cm in 76% of AIP patients as compared to 20% of PC. In AIP patients, the degree of narrowing of the MPD varied in the same patient, and skipped, narrowed lesions of the MPD were detected in 35% of our AIP patients, but in none of the PC patients. In AIP patients with segmental narrowing of the MPD, upstream dilatation of the distal MPD was less often noted than in PC. The maximal diameter of the upstream MPD on ERP was in segmental AIP patients, which was significantly smaller than in pancreatic head cancer patients ( ). The maximal diameter of the upstream MPD was smaller than 5 mm in 94% of segmental AIP patients. Side branches were more frequently derived from the narrowed portion of the MPD in AIP patients (65%) than in PC patients (25%). Similar results were seen in studies by Wakabayashi et al. [ 15 ] and Takuma et al. [ 24 ] comparing ERCP findings in AIP and PC.