Groove pancreatitis vs. pancreatic adenocarcinoma: A review of 8 cases

Abstract

Introduction: Groove pancreatitis (PS) is an uncommon clinical situation and radiologically it can mimic carcinoma of the periampullary area. The aim of this paper is to study a series of 8 patients who underwent surgery with preoperative diagnosis of pancreatic head mass and subsequent pathological diagnosis of PS.

Methods: In our series, 6 were men and 2 women, with an average age of 51,9 years. Before surgery, all patients had epigastric abdominal pain requiring analgesia at high doses. The preoperative analytical CEA and Ca 19.9 were normal in all patients. Imaging studies showed intrapancreatic solid lesions in 6 of the 8 patients, and in the remaining 2 one papillary mass of 5 and 6cm, respectively, that caused stenosis in the duodenal luz. EUS neoplastic cells were negative in all patients.

Results: The immediate postoperative evolution was satisfactory, there are no complications. In our series, no patients have died. The long-term follow-up, in 7 of the 8 patients, has been excellent with disappearance of abdominal pain and improvement of nutritional status. The remaining patient had frequent recurrent episodes of acute pancreatitis, and at 60 months, presented a pseudocyst that has required a Roux-en-Y cystojejunostomy.

Conclusions: PS must be included in the differential diagnosis of pancreatic lesions, which may include carcinoma of the periampullary area and other causes of chronic pancreatitis.

Keywords: Cáncer de páncreas; Duodenopancreatectomía; Groove pancreatitis; Pancreas; Pancreatic cancer; Pancreatico–duodenectomy; Pancreatitis del surco; Páncreas.