8例沟槽状胰腺炎外科治疗及文献复习_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

杨乐 , 王幸 , 谭春路 ,  刘续宝

四川大学华西医院胰腺外科（成都 610041）;

Corresponding author：

刘续宝, Email: xbliu@medmail.com.cn

Keywords：

沟槽状胰腺炎; 临床表现; 影像特征; 手术治疗; 保留胰头的十二指肠切除术

DOI：

10.7507/1007-9424.202112047

Video：

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目的探讨沟槽状胰腺炎（groove pancreatitis，GP）的临床特点、诊断及外科治疗。方法回顾性收集2020年1月至2021年7月期间四川大学华西医院胰腺外科收治的GP患者的临床病理资料并检索PubMed数据库进行文献复习，总结该病的临床表现、影像特征、外科治疗方案及效果。结果本研究共收集到四川大学华西医院收治的GP患者8例，主要临床症状有腹痛7例、呕吐6例和体质量减轻5例。CT表现主要为胰腺沟槽区低密度占位（8例），可侵犯到胰头（6例），十二指肠管壁不均匀增厚（7例）。8例患者均接受手术治疗，其中2例行保留胰头的十二指肠切除术、6例行胰十二指肠切除术。术后随访3～18个月，7例腹痛患者腹痛症状均得到改善，5例体质量减轻患者术后体质量明显增加。文献复习共收集到39例资料完整的患者，多为男性（87.2%），多有大量饮酒史（82.1%）。临床表现主要有腹痛（94.9%）、呕吐（76.9%）、体质量减轻（92.3%）。CT主要表现为胰十二指肠复合体受累或胰头区肿大（86.5%）及十二指肠壁不均匀增厚（64.9%）。除1例行全胰腺切除术外其余患者均行胰十二指肠切除术，术后20例患者疼痛完全缓解。结论 GP临床症状无特异。胰十二指肠切除术是目前最主要的手术选择，对于胰头尚未受侵犯的单纯型GP采用保留胰头的十二指肠切除术可能可行。

Citation： 杨乐, 王幸, 谭春路, 刘续宝. 8例沟槽状胰腺炎外科治疗及文献复习. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2022, 29(9): 1220-1225. doi: 10.7507/1007-9424.202112047 Copy

1.	Ishigami K, Tajima T, Nishie A, et al. Differential diagnosis of groove pancreatic carcinomas vs. groove pancreatitis: usefulness of the portal venous phase. Eur J Radiol, 2010, 74(3): e95-e100. doi: 10.1016/j.ejrad.2009.04.026.
2.	Casetti L, Bassi C, Salvia R, et al. “Paraduodenal” pancreatitis: results of surgery on 58 consecutives patients from a single institution. World J Surg, 2009, 33(12): 2664-2669.
3.	Suda K, Takase M, Shiono S, et al. Duodenal wall cysts may be derived from a ductal component of ectopic pancreatic tissue. Histopathology, 2002, 41(4): 351-356.
4.	Aoun N, Zafatayeff S, Smayra T, et al. Adenomyoma of the ampullary region: imaging findings in four patients. Abdom Imaging, 2005, 30(1): 86-89.
5.	McFaul CD, Vitone LJ, Campbell F, et al. Pancreatic hamartoma. Pancreatology, 2004, 4(6): 533-537.
6.	Potet F, Duclert N. Cystic dystrophy on aberrant pancreas of the duodenal wall. Arch Fr Mal App Dig, 1970, 59(4): 223-238.
7.	Adsay NV, Zamboni G. Paraduodenal pancreatitis: a clinico-pathologically distinct entity unifying “cystic dystrophy of heterotopic pancreas”, “para-duodenal wall cyst”, and “groove pancreatitis”. Semin Diagn Pathol, 2004, 21(4): 247-254.
8.	Stolte M, Weiss W, Volkholz H, et al. A special form of segmental pancreatitis: “groove pancreatitis”. Hepatogastroenterology, 1982, 29(5): 198-208.
9.	Becker V, Mischke U. Groove pancreatitis. Int J Pancreatol, 1991, 10(3-4): 173-182.
10.	Aguilera F, Tsamalaidze L, Raimondo M, et al. Pancreaticoduodenectomy and outcomes for groove pancreatitis. Dig Surg, 2018, 35(6): 475-481.
11.	de Pretis N, Capuano F, Amodio A, et al. Clinical and morphological features of paraduodenal pancreatitis: an Italian experience with 120 patients. Pancreas, 2017, 46(4): 489-495.
12.	Zhang S, Wang C, Huang H, et al. Effects of alcohol drinking and smoking on pancreatic ductal adenocarcinoma mortality: a retrospective cohort study consisting of 1 783 patients. Sci Rep, 2017, 7(1): 9572. doi: 10.1038/s41598-017-08794-1.
13.	Addeo G, Beccani D, Cozzi D, et al. Groove pancreatitis: a challenging imaging diagnosis. Gland Surg, 2019, 8(Suppl 3): S178-S187. doi: 10.21037/gs.2019.04.06.
14.	Zen Y, Deshpande V. Tumefactive inflammatory diseases of the pancreas. Am J Pathol, 2019, 189(1): 82-93.
15.	Pallisera-Lloveras A, Ramia-Ángel JM, Vicens-Arbona C, et al. Groove pancreatitis. Rev Esp Enferm Dig, 2015, 107(5): 280-288.
16.	DeSouza K, Nodit L. Groove pancreatitis: a brief review of a diagnostic challenge. Arch Pathol Lab Med, 2015, 139(3): 417-421.
17.	Tezuka K, Makino T, Hirai I, et al. Groove pancreatitis. Dig Surg, 2010, 27(2): 149-152.
18.	Latham J, Sanjay P, Watt DG, et al. Groove pancreatitis: a case series and review of the literature. Scott Med J, 2013, 58(1): e28-e31. doi: 10.1177/0036933012474610.
19.	Arvanitakis M, Rigaux J, Toussaint E, et al. Endotherapy for paraduodenal pancreatitis: a large retrospective case series. Endoscopy, 2014, 46(7): 580-587.
20.	Triantopoulou C, Dervenis C, Giannakou N, et al. Groove pancreatitis: a diagnostic challenge. Eur Radiol, 2009, 19(7): 1736-1743.
21.	Vitali F, Hansen T, Kiesslich R, et al. Frequency and characterization of benign lesions in patients undergoing surgery for the suspicion of solid pancreatic neoplasm. Pancreas, 2014, 43(8): 1329-1333.
22.	Zaheer A, Haider M, Kawamoto S, et al. Dual-phase CT findings of groove pancreatitis. Eur J Radiol, 2014, 83(8): 1337-1343.
23.	Patel BN, Brooke Jeffrey R, Olcott EW, et al. Groove pancreatitis: a clinical and imaging overview. Abdom Radiol (NY), 2020, 45(5): 1439-1446.
24.	Blasbalg R, Baroni RH, Costa DN, et al. MRI features of groove pancreatitis. AJR Am J Roentgenol, 2007, 189(1): 73-80.
25.	Mittal PK, Harri P, Nandwana S, et al. Paraduodenal pancreatitis: benign and malignant mimics at MRI. Abdom Radiol (NY), 2017, 42(11): 2652-2674.
26.	Perez-Johnston R, Sainani NI, Sahani DV. Imaging of chronic pancreatitis (including groove and autoimmune pancreatitis). Radiol Clin North Am, 2012, 50(3): 447-466.
27.	Egorov VI, Vankovich AN, Petrov RV, et al. Pancreas-preserving approach to “paraduodenal pancreatitis” treatment: why, when, and how? Experience of treatment of 62 patients with duodenal dystrophy. Biomed Res Int, 2014, 2014: 185265. doi: 10.1155/2014/185265.
28.	Raman SP, Salaria SN, Hruban RH, et al. Groove pancreatitis: spectrum of imaging findings and radiology-pathology correlation. AJR Am J Roentgenol, 2013, 201(1): W29-W39. doi: 10.2214/AJR.12.9956.
29.	Kempeneers MA, Issa Y, Ali UA, et al. International consensus guidelines for surgery and the timing of intervention in chronic pancreatitis. Pancreatology, 2020, 20(2): 149-157.
30.	Kager LM, Lekkerkerker SJ, Arvanitakis M, et al. Outcomes after conservative, endoscopic, and surgical treatment of groove pancreatitis: a systematic review. J Clin Gastroenterol, 2017, 51(8): 749-754.
31.	Egorov VI, Butkevich AC, Sazhin AV, et al. Pancreas-preserving duodenal resections with bile and pancreatic duct replantation for duodenal dystrophy. Two case reports. JOP, 2010, 11(5): 446-452.
32.	Rahman SH, Verbeke CS, Gomez D, et al. Pancreatico-duodenectomy for complicated groove pancreatitis. HPB (Oxford), 2007, 9(3): 229-234.
33.	Tison C, Regenet N, Meurette G, et al. Cystic dystrophy of the duodenal wall developing in heterotopic pancreas: report of 9 cases. Pancreas, 2007, 34(1): 152-156.
34.	Carvalho D, Loureiro R, Pavão Borges V, et al. Paraduodenal pancreatitis: three cases with different therapeutic approaches. GE Port J Gastroenterol, 2017, 24(2): 89-94.
35.	Ray S, Ghatak S, Misra D, et al. Groove pancreatitis: report of three cases with brief review of literature. Indian J Surg, 2017, 79(4): 344-348.
36.	Barbu ST, Valeanu D, Muresan A, et al. Cystic dystrophy of the duodenal wall in heterotopic pancreas with groove pancreatitis: a diagnostic and therapeutic challenge. Chirurgia (Bucur), 2018, 113(3): 418-423.
37.	Mikulić D, Bubalo T, Mrzljak A, et al. Role of total pancreatectomy in the treatment of paraduodenal pancreatitis: a case report. World J Gastrointest Surg, 2019, 11(6): 296-302.
38.	Wang YL, Tong CH, Yu JH, et al. Complete duodenal obstruction induced by groove pancreatitis: a case report. World J Clin Cases, 2019, 7(23): 4106-4110.
39.	Balduzzi A, Marchegiani G, Andrianello S, et al. Pancreaticoduodenectomy for paraduodenal pancreatitis is associated with a higher incidence of diabetes but a similar quality of life and pain control when compared to medical treatment. Pancreatology, 2020, 20(2): 193-198.
40.	Ismail IB, Zenaidi H, Yahmadi A, et al. Surgical management of groove pancreatitis: a case report. Pan Afr Med J, 2020, 36: 99. doi: 10.11604/pamj.2020.36.99.21873.
41.	Jiang C, Liu X, Yao W, et al. Pancreatoduodenectomy for paraduodenal pancreatitis: a diagnostic and therapeutic challenge. J Int Med Res, 2020, 48(11): 300060520972576. doi: 10.1177/0300060520972576.
42.	Laudari U, Ghimire R, Pradhan R, et al. Diagnostic dilemma in groove pancreatitis: a case report. JNMA J Nepal Med Assoc, 2020, 58(231): 934-937.
43.	Zadeh J, Andreoni A, Febres-Aldana C, et al. Paraduodenal pancreatitis: a deceptive abdominal mass with unique histologic findings. Case Rep Surg, 2020, 2020: 5021578. doi: 10.1155/2020/5021578.
44.	Egorov V, Petrov R, Schegolev A, et al. Pancreas-preserving duodenal resections vs pancreatoduodenectomy for groove pancreatitis. Should we revisit treatment algorithm for groove pancreatitis?. World J Gastrointest Surg, 2021, 13(1): 30-49.

1. Ishigami K, Tajima T, Nishie A, et al. Differential diagnosis of groove pancreatic carcinomas vs. groove pancreatitis: usefulness of the portal venous phase. Eur J Radiol, 2010, 74(3): e95-e100. doi: 10.1016/j.ejrad.2009.04.026.
2. Casetti L, Bassi C, Salvia R, et al. “Paraduodenal” pancreatitis: results of surgery on 58 consecutives patients from a single institution. World J Surg, 2009, 33(12): 2664-2669.
3. Suda K, Takase M, Shiono S, et al. Duodenal wall cysts may be derived from a ductal component of ectopic pancreatic tissue. Histopathology, 2002, 41(4): 351-356.
4. Aoun N, Zafatayeff S, Smayra T, et al. Adenomyoma of the ampullary region: imaging findings in four patients. Abdom Imaging, 2005, 30(1): 86-89.
5. McFaul CD, Vitone LJ, Campbell F, et al. Pancreatic hamartoma. Pancreatology, 2004, 4(6): 533-537.
6. Potet F, Duclert N. Cystic dystrophy on aberrant pancreas of the duodenal wall. Arch Fr Mal App Dig, 1970, 59(4): 223-238.
7. Adsay NV, Zamboni G. Paraduodenal pancreatitis: a clinico-pathologically distinct entity unifying “cystic dystrophy of heterotopic pancreas”, “para-duodenal wall cyst”, and “groove pancreatitis”. Semin Diagn Pathol, 2004, 21(4): 247-254.
8. Stolte M, Weiss W, Volkholz H, et al. A special form of segmental pancreatitis: “groove pancreatitis”. Hepatogastroenterology, 1982, 29(5): 198-208.
9. Becker V, Mischke U. Groove pancreatitis. Int J Pancreatol, 1991, 10(3-4): 173-182.
10. Aguilera F, Tsamalaidze L, Raimondo M, et al. Pancreaticoduodenectomy and outcomes for groove pancreatitis. Dig Surg, 2018, 35(6): 475-481.
11. de Pretis N, Capuano F, Amodio A, et al. Clinical and morphological features of paraduodenal pancreatitis: an Italian experience with 120 patients. Pancreas, 2017, 46(4): 489-495.
12. Zhang S, Wang C, Huang H, et al. Effects of alcohol drinking and smoking on pancreatic ductal adenocarcinoma mortality: a retrospective cohort study consisting of 1 783 patients. Sci Rep, 2017, 7(1): 9572. doi: 10.1038/s41598-017-08794-1.
13. Addeo G, Beccani D, Cozzi D, et al. Groove pancreatitis: a challenging imaging diagnosis. Gland Surg, 2019, 8(Suppl 3): S178-S187. doi: 10.21037/gs.2019.04.06.
14. Zen Y, Deshpande V. Tumefactive inflammatory diseases of the pancreas. Am J Pathol, 2019, 189(1): 82-93.
15. Pallisera-Lloveras A, Ramia-Ángel JM, Vicens-Arbona C, et al. Groove pancreatitis. Rev Esp Enferm Dig, 2015, 107(5): 280-288.
16. DeSouza K, Nodit L. Groove pancreatitis: a brief review of a diagnostic challenge. Arch Pathol Lab Med, 2015, 139(3): 417-421.
17. Tezuka K, Makino T, Hirai I, et al. Groove pancreatitis. Dig Surg, 2010, 27(2): 149-152.
18. Latham J, Sanjay P, Watt DG, et al. Groove pancreatitis: a case series and review of the literature. Scott Med J, 2013, 58(1): e28-e31. doi: 10.1177/0036933012474610.
19. Arvanitakis M, Rigaux J, Toussaint E, et al. Endotherapy for paraduodenal pancreatitis: a large retrospective case series. Endoscopy, 2014, 46(7): 580-587.
20. Triantopoulou C, Dervenis C, Giannakou N, et al. Groove pancreatitis: a diagnostic challenge. Eur Radiol, 2009, 19(7): 1736-1743.
21. Vitali F, Hansen T, Kiesslich R, et al. Frequency and characterization of benign lesions in patients undergoing surgery for the suspicion of solid pancreatic neoplasm. Pancreas, 2014, 43(8): 1329-1333.
22. Zaheer A, Haider M, Kawamoto S, et al. Dual-phase CT findings of groove pancreatitis. Eur J Radiol, 2014, 83(8): 1337-1343.
23. Patel BN, Brooke Jeffrey R, Olcott EW, et al. Groove pancreatitis: a clinical and imaging overview. Abdom Radiol (NY), 2020, 45(5): 1439-1446.
24. Blasbalg R, Baroni RH, Costa DN, et al. MRI features of groove pancreatitis. AJR Am J Roentgenol, 2007, 189(1): 73-80.
25. Mittal PK, Harri P, Nandwana S, et al. Paraduodenal pancreatitis: benign and malignant mimics at MRI. Abdom Radiol (NY), 2017, 42(11): 2652-2674.
26. Perez-Johnston R, Sainani NI, Sahani DV. Imaging of chronic pancreatitis (including groove and autoimmune pancreatitis). Radiol Clin North Am, 2012, 50(3): 447-466.
27. Egorov VI, Vankovich AN, Petrov RV, et al. Pancreas-preserving approach to “paraduodenal pancreatitis” treatment: why, when, and how? Experience of treatment of 62 patients with duodenal dystrophy. Biomed Res Int, 2014, 2014: 185265. doi: 10.1155/2014/185265.
28. Raman SP, Salaria SN, Hruban RH, et al. Groove pancreatitis: spectrum of imaging findings and radiology-pathology correlation. AJR Am J Roentgenol, 2013, 201(1): W29-W39. doi: 10.2214/AJR.12.9956.
29. Kempeneers MA, Issa Y, Ali UA, et al. International consensus guidelines for surgery and the timing of intervention in chronic pancreatitis. Pancreatology, 2020, 20(2): 149-157.
30. Kager LM, Lekkerkerker SJ, Arvanitakis M, et al. Outcomes after conservative, endoscopic, and surgical treatment of groove pancreatitis: a systematic review. J Clin Gastroenterol, 2017, 51(8): 749-754.
31. Egorov VI, Butkevich AC, Sazhin AV, et al. Pancreas-preserving duodenal resections with bile and pancreatic duct replantation for duodenal dystrophy. Two case reports. JOP, 2010, 11(5): 446-452.
32. Rahman SH, Verbeke CS, Gomez D, et al. Pancreatico-duodenectomy for complicated groove pancreatitis. HPB (Oxford), 2007, 9(3): 229-234.
33. Tison C, Regenet N, Meurette G, et al. Cystic dystrophy of the duodenal wall developing in heterotopic pancreas: report of 9 cases. Pancreas, 2007, 34(1): 152-156.
34. Carvalho D, Loureiro R, Pavão Borges V, et al. Paraduodenal pancreatitis: three cases with different therapeutic approaches. GE Port J Gastroenterol, 2017, 24(2): 89-94.
35. Ray S, Ghatak S, Misra D, et al. Groove pancreatitis: report of three cases with brief review of literature. Indian J Surg, 2017, 79(4): 344-348.
36. Barbu ST, Valeanu D, Muresan A, et al. Cystic dystrophy of the duodenal wall in heterotopic pancreas with groove pancreatitis: a diagnostic and therapeutic challenge. Chirurgia (Bucur), 2018, 113(3): 418-423.
37. Mikulić D, Bubalo T, Mrzljak A, et al. Role of total pancreatectomy in the treatment of paraduodenal pancreatitis: a case report. World J Gastrointest Surg, 2019, 11(6): 296-302.
38. Wang YL, Tong CH, Yu JH, et al. Complete duodenal obstruction induced by groove pancreatitis: a case report. World J Clin Cases, 2019, 7(23): 4106-4110.
39. Balduzzi A, Marchegiani G, Andrianello S, et al. Pancreaticoduodenectomy for paraduodenal pancreatitis is associated with a higher incidence of diabetes but a similar quality of life and pain control when compared to medical treatment. Pancreatology, 2020, 20(2): 193-198.
40. Ismail IB, Zenaidi H, Yahmadi A, et al. Surgical management of groove pancreatitis: a case report. Pan Afr Med J, 2020, 36: 99. doi: 10.11604/pamj.2020.36.99.21873.
41. Jiang C, Liu X, Yao W, et al. Pancreatoduodenectomy for paraduodenal pancreatitis: a diagnostic and therapeutic challenge. J Int Med Res, 2020, 48(11): 300060520972576. doi: 10.1177/0300060520972576.
42. Laudari U, Ghimire R, Pradhan R, et al. Diagnostic dilemma in groove pancreatitis: a case report. JNMA J Nepal Med Assoc, 2020, 58(231): 934-937.
43. Zadeh J, Andreoni A, Febres-Aldana C, et al. Paraduodenal pancreatitis: a deceptive abdominal mass with unique histologic findings. Case Rep Surg, 2020, 2020: 5021578. doi: 10.1155/2020/5021578.
44. Egorov V, Petrov R, Schegolev A, et al. Pancreas-preserving duodenal resections vs pancreatoduodenectomy for groove pancreatitis. Should we revisit treatment algorithm for groove pancreatitis?. World J Gastrointest Surg, 2021, 13(1): 30-49.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

8例沟槽状胰腺炎外科治疗及文献复习

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