Ahmed Zeeshan, Tilloo Raviraj, Karunakaran Monish, Modak Shreeyash, Arora Prateek, Patil Sanjeev, Sekaran Anuradha, Ramchandani Mohan, Shetty Mahesh, Dama Rohit, Rebala Pradeep, Rao Guduru Venkat
Department of Surgical Gastroenterology, Asian Institute of Gastroenterology and AIG Hospitals, Hyderabad, India.
Department of Pathology, Asian Institute of Gastroenterology and AIG Hospitals, Hyderabad, India.
Ann Hepatobiliary Pancreat Surg. 2025 Aug 31;29(3):293-301. doi: 10.14701/ahbps.25-041. Epub 2025 May 26.
BACKGROUNDS/AIMS: Groove pancreatitis (GP) is a seldom encountered form of chronic pancreatitis characterized by inflammation of the pancreatoduodenal groove. Our study presents our experience with pancreatoduodenectomy (PD) for GP at a tertiary referral center.
We conducted a retrospective review of patients who underwent PD for a preoperative diagnosis of GP at a tertiary referral center from 2010 to 2024. The primary outcomes were long-term pain relief and risks of recurrent pancreatitis, exocrine, and endocrine insufficiency. Secondary outcomes included perioperative complications.
During the study period, 19 patients underwent PD for GP. The median age was 45.5 years, and all patients were male. Eighty percent of the patients had a history of alcohol consumption and smoking. The median duration of symptoms was 24 months, with pain being the most prevalent symptom (94.73%). The overall complication rate (Clavien-Dindo grades 1-5) was 52.63% (10/19), and the major complication rate (Clavien-Dindo grades 3-5) was 21.05%. The median follow-up period was 67.25 months. Complete pain relief was achieved in 73.33% (11/15) of the patients, with the remaining 26.66% (4/15) experiencing partial resolution of pain. Among these, all had recurrent pancreatitis in the remnant pancreas, with ongoing alcohol consumption (n = 3) or smoking (n = 4). New-onset diabetes mellitus and steatorrhea were observed in 42.85% (6/14) and 21.42% (3/14) of patients, respectively. Furthermore, 71.42% (10/14) reported weight gain, with a median increase of 13.5 kg (range 5.00-22.75 kg).
PD for GP offers substantial long-term pain relief with acceptable levels of perioperative morbidity and mortality.
背景/目的：沟状胰腺炎（GP）是一种罕见的慢性胰腺炎形式，其特征为胰十二指肠沟炎症。我们的研究展示了在一家三级转诊中心进行胰十二指肠切除术（PD）治疗GP的经验。
我们对2010年至2024年在一家三级转诊中心因术前诊断为GP而接受PD的患者进行了回顾性研究。主要结局是长期疼痛缓解以及复发性胰腺炎、外分泌和内分泌功能不全的风险。次要结局包括围手术期并发症。
在研究期间，19例患者因GP接受了PD。中位年龄为45.5岁，所有患者均为男性。80%的患者有饮酒和吸烟史。症状的中位持续时间为24个月，疼痛是最常见的症状（94.73%）。总体并发症发生率（Clavien-Dindo分级1 - 5级）为52.63%（10/19），主要并发症发生率（Clavien-Dindo分级3 - 5级）为21.05%。中位随访期为67.25个月。73.33%（11/15）的患者实现了完全疼痛缓解，其余26.66%（4/15）的患者疼痛部分缓解。其中，所有患者残留胰腺均发生复发性胰腺炎，伴有持续饮酒（n = 3）或吸烟（n = 4）。分别有42.85%（6/14）和21.42%（3/14）的患者出现新发糖尿病和脂肪泻。此外，71.42%（10/14）的患者报告体重增加，中位增加13.5 kg（范围5.00 - 22.75 kg）。
PD治疗GP可实现显著的长期疼痛缓解，围手术期发病率和死亡率处于可接受水平。
