Kim Joo Dong, Han Young Seok, Choi Dong Lak
Department of Surgery, Catholic University of Daegu School of Medicine, Deagu, Korea.
J Korean Surg Soc. 2011 May;80(5):342-7. doi: 10.4174/jkss.2011.80.5.342. Epub 2011 May 6.
Groove pancreatitis is a rare specific form of chronic pancreatitis that extends into the anatomical area between the pancreatic head, the duodenum, and the common bile duct, which are referred to as the groove areas. We present the diagnostic modalities, pathological features and clinical outcomes of a series of symptomatic patients with groove pancreatitis who underwent pancreaticoduodenectomy.
Six patients undergoing pancreaticoduodenectomy between May 2006 and May 2009 due to a clinical diagnosis of symptomatic groove pancreatitis were retrospectively included in the study.
Five cases were male and one case was female, with a median age at diagnosis of 50 years. Their chief complaints were abdominal pain and vomiting. Abdominal computed tomography, endoscopic ultrasound and endoscopic retrograde cholangiopancreatography were performed. Preoperative diagnosis of all patients was groove pancreatitis. Histological finding was compatible with clinically diagnosed groove pancreatitis in five patients and the pathologic diagnosis of the remaining patient was adenocarcinoma of distal common bile duct. Following pancreaticoduodenectomy, four living patients experienced significant pain alleviation.
The diagnostic imaging modalities of choice for groove pancreatitis are computed tomography and endoscopic ultrasonography. If symptomatic groove pancreatitis is suspected, careful follow-up of patients is necessary and pancreaticoduodenectomy seems to be a reasonable treatment option.
沟部胰腺炎是一种罕见的慢性胰腺炎特殊类型，其病变延伸至胰头、十二指肠和胆总管之间的解剖区域，即所谓的沟区。我们报告一系列因症状性沟部胰腺炎接受胰十二指肠切除术的患者的诊断方法、病理特征及临床结局。
回顾性纳入2006年5月至2009年5月间因临床诊断为症状性沟部胰腺炎而接受胰十二指肠切除术的6例患者。
5例为男性，1例为女性，诊断时的中位年龄为50岁。主要症状为腹痛和呕吐。均行腹部计算机断层扫描、内镜超声及内镜逆行胰胆管造影检查。所有患者术前诊断均为沟部胰腺炎。5例患者的组织学检查结果与临床诊断的沟部胰腺炎相符，其余1例患者的病理诊断为胆总管远端腺癌。胰十二指肠切除术后，4例存活患者的疼痛明显缓解。
沟部胰腺炎的首选诊断性影像学检查方法是计算机断层扫描和内镜超声检查。若怀疑为症状性沟部胰腺炎，对患者进行仔细随访很有必要，胰十二指肠切除术似乎是一种合理的治疗选择。
