Characteristics and outcomes of patients with autoimmune pancreatitis after pancreatectomy: a retrospective study

Objective: Autoimmune pancreatitis (AIP) is a rare and special type of pancreatitis, which is often difficult to distinguish from pancreatic cancer. We aimed to discuss the clinical characteristics, operation characteristics, and therapeutic effects of AIP patients who received surgical treatment based on retrospective analysis.Methods: The medical records of patients who underwent surgery at Peking Union Medical College Hospital from January 2012 to July 2021 and whose postoperative pathology was AIP were collected. Clinical symptoms, laboratory examinations, imaging features, surgical information, and prognostic data were analyzed.Results: Nineteen patients with AIP (median age 60 years old, 14 males) underwent surgery, whose main indication for surgery was suspected of a malignant lesion (n = 18, 94.7%). Ten patients underwent pancreaticoduodenectomy, 8 underwent distal pancreatectomy, and 1 underwent total pancreatectomy, the pathological result of whom were all AIP. The main postoperative complication was pancreatic fistula (n = 11, 57.9%), and one patient (5.3%) underwent a second operation due to gastrointestinal anastomotic bleeding. One patient (5.6%) had a recurrence of AIP, 3 patients (16.7%) were treated with glucocorticoid after surgery, and one patient (5.6%) was treated with immunosuppressors.Conclusions: Differential diagnosis of AIP from pancreatic cancer is complex. Operation difficulty and complication incidence for patients with AIP were similar to pancreatic cancer patients. Although glucocorticoid is the first-line treatment for AIP, surgery may still be necessary for patients who are strongly suspected of a malignant lesion.