Bibliographic Details
| Title: |
Endoscopic Retrograde Cholangiopancreatography-Related Procedures for the Differential Diagnosis of Isolated Immunoglobin G4-Related Sclerosing Cholangitis and Perihilar Cholangiocarcinoma. |
| Authors: |
Furukawa, Masaru1 (AUTHOR) mfurukawa@hiroshima-u.ac.jp, Ishii, Yasutaka1 (AUTHOR) yishii@hiroshima-u.ac.jp, Tatsukawa, Yumiko1 (AUTHOR), Nakamura, Shinya1 (AUTHOR), Ikemoto, Juri1 (AUTHOR), Miyamoto, Sayaka1 (AUTHOR), Nakamura, Kazuki1 (AUTHOR), Yamashita, Yumiko1 (AUTHOR), Iijima, Noriaki1 (AUTHOR), Okuda, Yasuhiro1 (AUTHOR), Nomura, Risa1 (AUTHOR), Arihiro, Koji2 (AUTHOR) arihiro@hiroshima-u.ac.jp, Hanada, Keiji3 (AUTHOR), Oka, Shiro1 (AUTHOR) |
| Source: |
Diagnostics (2075-4418). Aug2024, Vol. 14 Issue 15, p1621. 11p. |
| Subject Terms: |
*ENDOSCOPIC retrograde cholangiopancreatography, *BILE ducts, *DIFFERENTIAL diagnosis, *CHOLANGITIS, *CHOLANGIOCARCINOMA |
| Abstract: |
Background/Purpose: Differential diagnosis of isolated immunoglobin (Ig)G4-related sclerosing cholangitis (IgG4-SC) and cholangiocarcinoma is challenging. We aimed to clarify the role of endoscopic retrograde cholangiography (ERCP)-related procedures in the differential diagnosis of isolated IgG4-SC and perihilar cholangiocarcinoma (PHCC). Methods: Seven patients with hilar-type isolated IgG4-SC diagnosed at Hiroshima University Hospital and sixty-five patients with surgically resected invasive PHCC were enrolled, and the diagnostic yields of intraductal ultrasonography (IDUS), peroral cholangioscopy (POCS), and pathological examinations were determined. Results: In six of seven (86%) patients with isolated IgG4-SC, the stricture was in the perihilar bile duct. IDUS showed that symmetrical wall thickening (40% vs. 5%, p = 0.04), homogeneous internal echo (80% vs. 5%, p < 0.001), and smooth outer margins (80% vs. 6%, p < 0.001) were more frequent in isolated IgG4-SC than in PHCC. POCS showed a smooth mucosal surface more frequent in isolated IgG4-SC (75% vs. 7%, p = 0.006). Only one patient had two pathological findings characteristic of IgG4-SC. The sensitivity for diagnosing PHCC was 81% using two or more combined sampling methods. Conclusions: Pathological examinations have limitations in the differential diagnosis of isolated-IgG4-SC and PHCC, and a diagnostic strategy that combines multiple ERCP-related procedures, including IDUS and POCS, is recommended. [ABSTRACT FROM AUTHOR] |
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