Pancreaticoduodenectomy and Outcomes for Groove Pancreatitis

Abstract

Background/Aims: The operative management of groove pancreatitis (GP) is still a matter of controversy and pancreaticoduodenectomy (PD) can be a high-risk procedure for patients. The aim of this study was to report our 9-year experience of surgical resection for GP and to review relevant literature. Methods: A retrospective review of patients undergoing pancreatectomy for GP from August 1, 2008, through May 31, 2017 was performed. Patients with clinical, radiologic, and final pathologic confirmation of GP were included. Literature on the current understanding of GP was reviewed. Results: Eight patients from total 449 pancreatectomies met inclusion criteria. Four male and 4 female patients (mean age, 51.9 years; mean body mass index, 25.3) underwent pylorus-preserving pancreatoduodenectomy (3 by laparoscopy and 5 by open approach). Mean (range) operative time and blood loss was 343 (167–525) min and 218 (40–500) mL respectively. Pancreatic fistula and delayed gastric emptying were noted in one patient each. No major complications occurred, but minor complications occurred in 5 (62%) patients. Mean hospital stay was 6.1 (range 3–14) days. At median follow-up of 18.15 (interquartile range 7.25–33.8) months, all patients experienced a resolution of pancreatitis and improvement in symptoms. Conclusions: PD is a safe procedure for GP. Short-term surgical outcomes are acceptable and long-term outcomes are associated with improved symptom control.

Diagnosis, natural course and treatment outcomes of groove pancreatitis

“…6,10 Due to limited research, the treatment strategies vary from center to center, and there are no treatment guidelines on GP. Most of the literature concentrates on the surgical 4,7,[16][17][18][19][20] or endoscopic 6,21,22 treatment of GP, and there are only few studies reporting the results of conservative treatment of GP. 10,14,23 The aim of this study was to evaluate the diagnostics and the natural course of GP as well as the efficiency and safety of the different treatment strategies.…”

Pancreatoduodenectomy for paraduodenal pancreatitis: a diagnostic and therapeutic challenge

“…The reported incidence of PP varies significantly, [3][4][5][6] and it reportedly accounts for only 2% of cases of chronic pancreatitis after PD. 8 PP can be caused by anatomical obstruction in the minor papilla, by heavy smoking, or by alcohol toxicity-induced abnormal papillary function. Patients with PP generally present with abdominal pain coupled with nausea and postprandial vomiting.…”

Complete duodenal obstruction induced by groove pancreatitis: A case report

“…Some image examinations, such as multidetector computed tomography, magnetic resonance imaging, and ultrasound-guided fine needle aspiration, may provide more evidence for differential diagnosis between GP and pancreatic head carcinoma[6-10]. PD is a candidate surgical operation for GP while it is the only and standard surgical option for carcinomas of the pancreatic head[11-14]. Different from malignant diseases, groove resection of the pancreatic head is also considered a candidate surgical operation for patients with symptomatic GP that require a surgical intervention[15].…”