Menu
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.
The aim of this study was to analyze the clinical, imaging, and surgical treatment data of a series of patients diagnosed with GP.
The clinical, radiological, surgical, and postoperative follow-up data were analyzed, in addition to the histopathological results of chronic pancreatitis, in patients undergoing pancreaticoduodenectomy.
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.
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.
Although alcohol is the most common cause for chronic pancreatitis worldwide, idiopathic type is prevalent in India. Natural history and disease progression are different between these two groups. There is paucity of data comparing surgical outcome and quality of life in these patients.
To evaluate clinical features, surgical outcome and quality of life between these two groups of patients.
All patients with chronic pancreatitis who underwent surgery were prospectively reviewed.
From 98 patients, 42 were alcoholic. Number of male and the mean age at the time of operation was significantly more in alcoholic patients. Smoking, preoperative hospital admission rate and the prevalence of local complications like inflammatory pancreatic head mass, biliary stricture and left sided portal hypertension were distinctly more common in alcoholic group. Frey procedure was required more commonly in alcoholic group. Mean postoperative hospital stay and overall postoperative complication rate were comparable between the two groups. Over a median follow up of 18 months there was significant improvement in quality of life and pain score in both the groups. Improvement of physical functioning score at follow-up was significantly more in alcoholic group but the requirement for analgesic medications were significantly more in alcoholic group. However, appetite loss was more perceived by non-alcoholic group.
Alcoholic chronic pancreatitis presents with more local complications associated with chronic pancreatitis. Frey procedure is a safe and well accepted surgery in this group. Though they required more analgesic requirement in short term follow up, other aspects of quality of life are similar to non-alcoholic group.
Developed by Surya MKT