Pancreatoduodenectomy and surgical treatment of groove pancreatitis

Background:

Groove pancreatitis (GP) is a rare and segmental form of chronic pancreatitis that affects the pancreaticoduodenal sulcus. Its pathophysiology is still not well known, and several etiological factors have been attributed, with chronic alcohol consumption being the most common association. Its treatment still generates controversy. The initial clinical approach followed by endoscopic therapies prevails. Surgery is indicated when these treatment options fail.

Aims:

The aim of this study was to analyze the clinical, imaging, and surgical treatment data of a series of patients diagnosed with GP.

Methods:

The clinical, radiological, surgical, and postoperative follow-up data were analyzed, in addition to the histopathological results of chronic pancreatitis, in patients undergoing pancreaticoduodenectomy.

Results:

A total of eight patients were included, of whom six were male, and their mean age was 45 years. The main symptom presented was long-standing abdominal pain with the use of analgesics and weight loss; all patients were chronic alcoholics. Imaging methods defined the diagnosis of GP in the preoperative period in five patients. In three patients, the preoperative diagnosis was neoplasia of the head of the pancreas. All patients underwent pancreaticoduodenectomy and one patient developed pancreatic fistula. There was a regression of pain in all patients.

Conclusions:

For patients with GP who do not respond to the clinical approach, or in the face of diagnostic doubt, pancreaticoduodenectomy constitutes a good therapeutic option.