Surgical Management of Groove Pancreatitis: A Case Report

Abstract

Groove pancreatitis (GP) is a chronic type of pancreatitis involving the groove area between the head of the pancreas, the duodenum, and the common bile duct. Alcohol abuse is one of the main pathogenetic factors, although its etiology is not clearly defined. Differential diagnosis of pancreatic disorders remains difficult. The lack of diagnostic management and the restrictive number of patients are the main barriers. This article presents a case of a 37-year-old male diagnosed with GP after several episodes of epigastric pain and vomiting, with a history of chronic alcohol consumption. The patient’s radiological and laboratory results excluded the possibility of malignancy and suggested the diagnosis of groove pancreatitis with duodenal stenosis. After initial conservative treatment failed, surgical management was decided. A gastroenteroanastomosis was made in order to bypass the duodenum aiming for a total resolution of the symptoms and an uneventful recovery of the patient. Although most studies suggest pancreatoduodenectomy (Whipple’s procedure) as the treatment of choice, a less major procedure can be performed in evidence of malignancy absence.

Pancreaticoduodenectomy with Anatomical Vascular Variant in Groove Pancreatitis—A Case Report

“…Moreover, this approach cannot exclude pancreatic malignant degeneration if this suspicion exists. Duodenal or biliary bypass interventions can be useful in case of stenoses [15], but they address only the complications of pancreatitis and will have limited effects on symptom control. Pancreaticoduodenectomy, with or without pylorus preservation, represents the most commonly used technique for the treatment of groove pancreatitis, presenting a major advantage over all other procedures in which malignant degeneration cannot be excluded.…”