{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T21:43:46Z","timestamp":1755035026237},"reference-count":57,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2014,10,16]],"date-time":"2014-10-16T00:00:00Z","timestamp":1413417600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Digestive Endoscopy"],"published-print":{"date-parts":[[2015,1]]},"abstract":"<jats:p>Autoimmune pancreatitis (<jats:styled-content style=\"fixed-case\">AIP<\/jats:styled-content>) is characterized by diffuse pancreatic enlargement and irregular narrowing of the main pancreatic duct (<jats:styled-content style=\"fixed-case\">MPD<\/jats:styled-content>). Immunoglobulin (<jats:styled-content style=\"fixed-case\">Ig<\/jats:styled-content>)<jats:styled-content style=\"fixed-case\">G4<\/jats:styled-content>\u2010related sclerosing cholangitis (<jats:styled-content style=\"fixed-case\">IgG4<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">SC<\/jats:styled-content>) associated with <jats:styled-content style=\"fixed-case\">AIP<\/jats:styled-content> frequently appears as a bile duct stricture. Therefore, it is important to differentiate <jats:styled-content style=\"fixed-case\">AIP<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">IgG4<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">SC<\/jats:styled-content> from pancreatic cancer and cholangiocarcinoma or primary sclerosing cholangitis, respectively. Endoscopy plays a central role in the diagnosis of <jats:styled-content style=\"fixed-case\">AIP<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">IgG4<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">SC<\/jats:styled-content> because it provides imaging of the <jats:styled-content style=\"fixed-case\">MPD<\/jats:styled-content> and bile duct strictures as well as the ability to obtain tissue samples for histological evaluations. Diffuse irregular narrowing of <jats:styled-content style=\"fixed-case\">MPD<\/jats:styled-content> on endoscopic retrograde cholangiopancreatography (<jats:styled-content style=\"fixed-case\">ERCP<\/jats:styled-content>) is rather specific to <jats:styled-content style=\"fixed-case\">AIP<\/jats:styled-content>, but localized narrowing of the <jats:styled-content style=\"fixed-case\">MPD<\/jats:styled-content> is often difficult to differentiate from <jats:styled-content style=\"fixed-case\">MPD<\/jats:styled-content> stenosis caused by pancreatic cancer. A long stricture (&gt;1\/3 the length of the <jats:styled-content style=\"fixed-case\">MPD<\/jats:styled-content>) and lack of upstream dilatation from the stricture (&lt;5\u2009mm) might be key features of <jats:styled-content style=\"fixed-case\">AIP<\/jats:styled-content> on <jats:styled-content style=\"fixed-case\">ERCP<\/jats:styled-content>. Some cholangiographic features, such as segmental strictures, stric tures of the lower bile duct, and long strictures with prestenotic dilatation, are more common in <jats:styled-content style=\"fixed-case\">IgG4<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">SC<\/jats:styled-content> than in cholangiocarcinoma. Endoscopic ultrasonography (<jats:styled-content style=\"fixed-case\">EUS<\/jats:styled-content>) reveals diffuse hypoechoic pancreatic enlargement, sometimes with hypoechoic inclusions, in patients with <jats:styled-content style=\"fixed-case\">AIP<\/jats:styled-content>. In addition, <jats:styled-content style=\"fixed-case\">EUS<\/jats:styled-content>\u2010elastography and contrast\u2010enhanced harmonic <jats:styled-content style=\"fixed-case\">EUS<\/jats:styled-content> have been developed with promising results. The usefulness of <jats:styled-content style=\"fixed-case\">EUS<\/jats:styled-content>\u2010guided fine\u2010needle aspiration has been increasingly recognized for obtaining adequate tissue samples for the histological diagnosis of <jats:styled-content style=\"fixed-case\">AIP<\/jats:styled-content>. Further improvement of endoscopic procedures and devices will contribute to more accurate diagnosis of <jats:styled-content style=\"fixed-case\">AIP<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">IgG4<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">SC<\/jats:styled-content>.<\/jats:p>","DOI":"10.1111\/den.12343","type":"journal-article","created":{"date-parts":[[2014,8,13]],"date-time":"2014-08-13T13:54:00Z","timestamp":1407938040000},"page":"250-258","source":"Crossref","is-referenced-by-count":17,"title":["Endoscopic approaches for the diagnosis of autoimmune pancreatitis"],"prefix":"10.1111","volume":"27","author":[{"given":"Atsushi","family":"Kanno","sequence":"first","affiliation":[{"name":"Division of Gastroenterology Tohoku University Graduate School of Medicine  Sendai Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsushi","family":"Masamune","sequence":"additional","affiliation":[{"name":"Division of 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