Kager Liesbeth M, Lekkerkerker Selma J, Arvanitakis Marianna, Delhaye Myriam, Fockens Paul, Boermeester Marja A, van Hooft Jeanin E, Besselink Marc G
*Department of Gastroenterology & Hepatology, Noordwest Ziekenhuisgroep, Alkmaar Departments of †Gastroenterology & Hepatology §Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands ‡Department of Gastroenterology & Hepatology, Hepatopancreatology and GI Oncology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium.
J Clin Gastroenterol. 2017 Sep;51(8):749-754. doi: 10.1097/MCG.0000000000000746.
Groove pancreatitis (GP) is a focal form of chronic pancreatitis affecting the paraduodenal groove area, for which consensus on diagnosis and management is lacking.
We performed a systematic review of the literature to determine patient characteristics and imaging features of GP and to evaluate clinical outcomes after treatment.
Eight studies were included reporting on 335 GP patients with a median age of 47 years (range, 34 to 64 y), with 90% male, 87% smokers, and 87% alcohol consumption, and 47 months (range, 15 to 122 mo) of follow-up. Most patients presented with abdominal pain (91%) and/or weight loss (78%). Imaging frequently showed cystic lesions (91%) and duodenal stenosis (60%).Final treatment was conservative (eg, pain medication) in 29% of patients. Endoscopic treatment (eg, pseudocyst drainage) was applied in 19% of patients-34% of these patients were subsequently referred for surgery. Overall, 59% of patients were treated surgically (eg, pancreatoduodenectomy). Complete symptom relief was observed in 50% of patients who were treated conservatively, 57% who underwent endoscopic treatment, and 79% who underwent surgery.
GP is associated with male gender, smoking, and alcohol consumption. The vast majority of patients presents with abdominal pain and with cystic lesions on imaging. Although surgical treatment seems to be the most effective, both conservative and endoscopic treatment are successful in about half of patients. A stepwise treatment algorithm starting with the least invasive treatment options seems advisable.
沟部胰腺炎（GP）是一种累及十二指肠旁沟区域的局灶性慢性胰腺炎，目前在诊断和治疗方面缺乏共识。
我们对文献进行了系统综述，以确定GP患者的特征和影像学表现，并评估治疗后的临床结局。
纳入8项研究，共报道335例GP患者，中位年龄47岁（范围34至64岁），90%为男性，87%有吸烟史，87%有饮酒史，随访时间47个月（范围15至122个月）。大多数患者表现为腹痛（91%）和/或体重减轻（78%）。影像学检查常显示囊性病变（91%）和十二指肠狭窄（60%）。29%的患者最终接受保守治疗（如止痛药物）。19%的患者接受了内镜治疗（如假性囊肿引流），其中34%的患者随后接受了手术治疗。总体而言，59%的患者接受了手术治疗（如胰十二指肠切除术）。保守治疗的患者中50%症状完全缓解，接受内镜治疗的患者中57%症状完全缓解，接受手术治疗的患者中79%症状完全缓解。
GP与男性、吸烟和饮酒有关。绝大多数患者表现为腹痛，影像学检查显示囊性病变。虽然手术治疗似乎是最有效的，但保守治疗和内镜治疗在约一半的患者中也取得了成功。从侵入性最小的治疗方案开始的逐步治疗算法似乎是可取的。
