Pancreaticoduodenectomy and Outcomes for Groove Pancreatitis

Dig Surg. 2018;35(6):475-481. doi: 10.1159/000485849. Epub 2018 Jan 18.

Abstract

Background/aims: The operative management of groove pancreatitis (GP) is still a matter of controversy and pancreaticoduodenectomy (PD) can be a high-risk procedure for patients. The aim of this study was to report our 9-year experience of surgical resection for GP and to review relevant literature.

Methods: A retrospective review of patients undergoing pancreatectomy for GP from August 1, 2008, through May 31, 2017 was performed. Patients with clinical, radiologic, and final pathologic confirmation of GP were included. Literature on the current understanding of GP was reviewed.

Results: Eight patients from total 449 pancreatectomies met inclusion criteria. Four male and 4 female patients (mean age, 51.9 years; mean body mass index, 25.3) underwent pylorus-preserving pancreatoduodenectomy (3 by laparoscopy and 5 by open approach). Mean (range) operative time and blood loss was 343 (167-525) min and 218 (40-500) mL respectively. Pancreatic fistula and delayed gastric emptying were noted in one patient each. No major complications occurred, but minor complications occurred in 5 (62%) patients. Mean hospital stay was 6.1 (range 3-14) days. At median follow-up of 18.15 (interquartile range 7.25-33.8) months, all patients experienced a resolution of pancreatitis and improvement in symptoms.

Conclusions: PD is a safe procedure for GP. Short-term surgical outcomes are acceptable and long-term outcomes are associated with improved symptom control.

Keywords: Groove pancreatitis; Pancreatitis Pancreaticoduodenectomy; Whipple.

Publication types

  • Review

MeSH terms

  • Abdominal Pain / etiology
  • Adult
  • Blood Loss, Surgical
  • Female
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Nausea / etiology
  • Operative Time
  • Pancreaticoduodenectomy* / adverse effects
  • Pancreaticoduodenectomy* / methods
  • Pancreatitis, Chronic / complications
  • Pancreatitis, Chronic / surgery*
  • Patient Selection
  • Retrospective Studies
  • Treatment Outcome
  • Vomiting / etiology
  • Weight Loss