Annals of hepato-biliary-pancreatic surgery · 2025
Long-term outcomes of pancreato-duodenectomy for groove pancreatitis: A retrospective experience from a tertiary referral center.
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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
Аннотация
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.
METHODS: 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.
RESULTS: 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).
CONCLUSIONS: PD for GP offers substantial long-term pain relief with acceptable levels of perioperative morbidity and mortality.
METHODS: 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.
RESULTS: 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).
CONCLUSIONS: PD for GP offers substantial long-term pain relief with acceptable levels of perioperative morbidity and mortality.