Pancreatoduodenectomy for groove pancreatitis: A case report and literature review

Abstract

Groove pancreatitis represents a rare pathological condition which is usually associated with chronic alcohol intake. However, the differential diagnosis between groove pancreatitis and groove pancreatic carcinoma is difficult to establish pre-operatively. In this respect, a significant number of cases are treated as malignant conditions, with the final diagnosis of benign disease being established post-operatively. The present study describes the case of a 46-year-old male who was diagnosed with groove pancreatitis. Due to the uncertainty of the pre-operative diagnosis, the patient was subjected to radical surgery consisting of pancreatoduodenectomy. The final histopathological diagnosis confirmed the presence of groove pancreatitis. Moreover, it excluded the possibility of an association with any element of malignancy and provided the effective management of the disease, all the symptoms being significantly alleviated at the 3-month follow-up. In addition, the present study also provides a brief summary and discussion of the disease and associated treatment options. On the whole, as demonstrated herein, pancreatoduodenectomy appears to be a safe and effective method for the treatment of groove pancreatitis, being associated with a significant improvement in the quality of life of the patient; moreover, it represents the sole method which can exclude the diagnosis of malignancy.

Surgical Management of Groove Pancreatitis: A Case Report

“…Groove pancreatitis (GP), also known as paraduodenal pancreatitis, is a form of chronic pancreatitis located in the pancreaticoduodenal groove [3]. The groove area refers to the anatomic space between the pancreatic head medially, the second segment of the duodenum laterally, the third segment of the duodenum and inferior vena cava posteriorly, and the first segment of the duodenum superiorly [4]. GP is mainly associated with long-term alcohol intake and has also been reported in patients with known peptic ulcer disease and among children with a congenital origin [5].…”

“…In case patients are not clinically improved, present with complications, or the possibility of malignancy cannot be ruled out, the most suitable approach is surgery. Pancreatoduodenectomy, with Whipple's procedure or with preservation of pylorus-Longmire technique, is the most commonly used method because it provides both a definitive cure of the symptoms and resection of possible malignancy [4,7,10]. Casetti et al observed a percentage of 76% pain remission in patients after pancreatoduodenectomy [7].…”