Department of Internal Medicine and Hepatogastroenterology, Kasr Al-Aini School of Medicine, Cairo University, Cairo, Egypt.
Theodor Bilharz Research Institute, Mouwasat Hospital Dammam, Giza, Egypt.
Turk J Gastroenterol. 2023 Jul;34(7):771-778. doi: 10.5152/tjg.2023.22875.
BACKGROUND/AIMS: Groove pancreatitis is a rare form of focal pancreatitis that affects the groove area. Since groove pancreatitis may be mistaken for malignancy, it should be considered in patients with pancreatic head mass lesions or duodenal stenosis to avoid unnecessary surgical procedures. The aim of the study was to document the clinical, radiologic, endoscopic characteristics, and treatment outcomes of patients with groove pancreatitis.
This retrospective multicenter observational study included all patients diagnosed with one or more imaging criteria suggestive of groove pancreatitis in the participating centers. Patients with proven malignant fine-needle aspiration/biopsy results were excluded. All patients were followed in their own centers and were retrospectively evaluated.
Out of the initially included 30 patients with imaging criteria suggestive of groove pancreatitis, 9 patients (30%) were excluded because of malignant endoscopic ultrasound fine-needle aspiration or biopsy results. The mean age of the included 21 patients was 49 ± 10.6 years, with a male predominance of 71%. There was a history of smoking in 66.7% and alcohol consumption in 76.2% of patients. The main endoscopic finding was gastric outlet obstruction observed in 16 patients (76%). There was duodenal wall thickening in 9 (42.8%), 5 (23.8%), and 16 (76.2%) patients on computed tomography, magnetic resonance imaging, and endoscopic ultrasound, respectively. Moreover, pancreatic head enlargement/mass was observed in 10 (47.6%), 8 (38%), and 12 (57%) patients, and duodenal wall cysts in 5 (23.8%), 1 (4.8%), and 11 (52.4%) patients, respectively. Conservative and endoscopic treatment has achieved favorable outcomes in more than 90% of patients.
Groove pancreatitis should be considered in any case with duodenal stenosis, duodenal wall cysts, or thickening of the groove area. Various imaging modalities, including computerized tomography, endoscopic ultrasound, and magnetic resonance imaging, have a valuable role in characterizing groove pancreatitis. However, endoscopic fine-needle aspiration or biopsy should be considered in all cases to diagnose groove pancreatitis and exclude malignancy, which can have similar findings.
背景/目的：沟槽性胰腺炎是一种罕见的局灶性胰腺炎，影响沟槽区域。由于沟槽性胰腺炎可能被误诊为恶性肿瘤，因此对于胰腺头部肿块病变或十二指肠狭窄的患者，应考虑到这种疾病，以避免不必要的手术。本研究的目的是记录沟槽性胰腺炎患者的临床、放射学、内镜特征和治疗结果。
这是一项回顾性多中心观察性研究，纳入了所有在参与中心中通过一种或多种影像学标准疑似患有沟槽性胰腺炎的患者。排除了经证实的恶性细针抽吸/活检结果的患者。所有患者均在各自的中心进行随访，并进行回顾性评估。
在最初纳入的 30 名具有影像学标准疑似沟槽性胰腺炎的患者中，有 9 名（30%）因内镜超声细针抽吸或活检的恶性结果而被排除。纳入的 21 名患者的平均年龄为 49 ± 10.6 岁，男性占 71%。66.7%的患者有吸烟史，76.2%的患者有饮酒史。主要的内镜发现是 16 名患者（76%）出现胃出口梗阻。9 名（42.8%）、5 名（23.8%）和 16 名（76.2%）患者在 CT、磁共振成像和内镜超声检查中分别发现十二指肠壁增厚。此外，10 名（47.6%）、8 名（38%）和 12 名（57%）患者发现胰头部增大/肿块，5 名（23.8%）、1 名（4.8%）和 11 名（52.4%）患者发现十二指肠壁囊肿。超过 90%的患者接受保守和内镜治疗后取得了良好的效果。
对于任何有十二指肠狭窄、十二指肠壁囊肿或沟槽区域增厚的病例，都应考虑沟槽性胰腺炎。包括计算机断层扫描、内镜超声和磁共振成像在内的各种影像学方法在描述沟槽性胰腺炎方面具有重要作用。然而，在所有病例中都应考虑进行内镜细针抽吸或活检，以诊断沟槽性胰腺炎并排除恶性肿瘤，因为恶性肿瘤可能有类似的表现。
