Journal of Gastroenterology

, Volume 47, Issue 5, pp 553–560 | Cite as

Risk factors for pancreatic stone formation in autoimmune pancreatitis over a long-term course

  • Masahiro Maruyama
  • Norikazu Arakura
  • Yayoi Ozaki
  • Takayuki Watanabe
  • Tetsuya Ito
  • Suguru Yoneda
  • Masafumi Maruyama
  • Takashi Muraki
  • Hideaki Hamano
  • Akihiro Matsumoto
  • Shigeyuki KawaEmail author
Original Article—Liver, Pancreas, and Biliary Tract



Autoimmune pancreatitis (AIP) has the potential to progress to a chronic state that forms pancreatic stones. The aim of this study was to clarify the risk factors underlying pancreatic stone formation in AIP.


Sixty-nine patients with AIP who had been followed for at least 3 years were enrolled for evaluation of clinical and laboratory factors as well as computed tomography and endoscopic retrograde cholangiopancreatography findings.


During the course of this study, increased or de novo stone formation was seen in 28 patients, who were defined as the stone-forming group. No stones were observed in 32 patients, who were defined as the non-stone-forming group. Nine patients who had stones at diagnosis but showed no change during the course of this study were excluded from our cohort. Univariate analysis revealed no significant differences in clinical or laboratory factors associated with AIP-specific inflammation between the two groups. However, pancreatic head swelling (P = 0.006) and narrowing of both Wirsung’s and Santorini’s ducts in the pancreatic head region (P = 0.010) were significantly more frequent in the stone-forming group. Furthermore, multivariate analysis identified Wirsung and Santorini duct narrowing at diagnosis as a significant independent risk factor for pancreatic stone formation (OR 4.4, P = 0.019).


A primary risk factor for pancreatic stone formation in AIP was narrowing of both Wirsung’s and Santorini’s ducts, which most presumably led to pancreatic juice stasis and stone development.


Autoimmune pancreatitis Pancreatic stone Wirsung duct Santorini duct 



Autoimmune pancreatitis


Computed tomography


Endoscopic retrograde cholangiopancreatography



This work was supported partially by the Research Program of Intractable Disease provided by the Ministry of Health, Labor, and Welfare of Japan, and in part by Grants-in-aid for Scientific Research from the Ministry of Education, Science, Sports, and Culture of Japan (23591012). We thank Trevor Ralph for his English editorial assistance.

Conflict of interest

None of the authors have any conflicts of interest associated with this study.


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Copyright information

© Springer 2011

Authors and Affiliations

  • Masahiro Maruyama
    • 1
  • Norikazu Arakura
    • 2
  • Yayoi Ozaki
    • 1
  • Takayuki Watanabe
    • 1
  • Tetsuya Ito
    • 1
  • Suguru Yoneda
    • 1
  • Masafumi Maruyama
    • 1
  • Takashi Muraki
    • 1
  • Hideaki Hamano
    • 1
  • Akihiro Matsumoto
    • 1
  • Shigeyuki Kawa
    • 3
    Email author
  1. 1.Department of GastroenterologyShinshu University School of MedicineMatsumotoJapan
  2. 2.Endoscopic Examination CenterShinshu University School of MedicineMatsumotoJapan
  3. 3.Center for Health, Safety, and Environmental ManagementShinshu UniversityMatsumotoJapan

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