Kohtaro Ooka1, Harkirat Singh2, Matthew G Warndorf3, Melissa Saul4, Andrew D Althouse5, Anil K Dasyam6, Pedram Paragomi7, Anna Evans Phillips8, Amer H Zureikat9, Kenneth K Lee10, Adam Slivka11, Georgios I Papachristou12, Dhiraj Yadav13. 1. New York University, Division of Gastroenterology and Hepatology, USA. Electronic address: kohook1@gmail.com. 2. University of Pittsburgh, Division of Gastroenterology, Hepatology and Nutrition, USA. Electronic address: singhh3@upmc.edu. 3. Albany Gastroenterology Consultants, USA. Electronic address: mwarndorf@gmail.com. 4. Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA. Electronic address: mis18@pitt.edu. 5. University of Pittsburgh, Center for Research on Health Care Data Center, USA. Electronic address: ada62@pitt.edu. 6. University of Pittsburgh, Department of Radiology, USA. Electronic address: dasyamak@upmc.edu. 7. University of Pittsburgh, Division of Gastroenterology, Hepatology and Nutrition, USA. Electronic address: pedram.paragomi@gmail.com. 8. University of Pittsburgh, Division of Gastroenterology, Hepatology and Nutrition, USA. Electronic address: evansac3@upmc.edu. 9. University of Pittsburgh, Division of Surgical Oncology, USA. Electronic address: zureikatah@upmc.edu. 10. University of Pittsburgh, Division of Surgical Oncology, USA. Electronic address: leek@upmc.edu. 11. University of Pittsburgh, Division of Gastroenterology, Hepatology and Nutrition, USA. Electronic address: slivkaa@upmc.edu. 12. Ohio State University Wexner Medical Center, Division of Gastroenterology, Hepatology and Nutrition, USA. Electronic address: georgios.papachristou@osumc.edu. 13. University of Pittsburgh, Division of Gastroenterology, Hepatology and Nutrition, USA. Electronic address: yadavd@upmc.edu.
Abstract
BACKGROUND & AIMS: The natural history of groove pancreatitis is incompletely characterized. Published literature suggests a high rate of surgery. We describe the short- and long-term outcomes in a cohort of patients with groove pancreatitis treated at our institution. METHODS: Medical records of patients hospitalized in the University of Pittsburgh Medical Center system from 2000 to 2014 and diagnosed with groove pancreatitis based on imaging were retrospectively reviewed. Clinical presentation and outcomes during index admission and follow-up were recorded. RESULTS: Forty-eight patients with groove pancreatitis were identified (mean age 53.2 years, 79% male). Seventy-one percent were alcohol abusers and an equal number were cigarette smokers. Prior histories of acute and chronic pancreatitis were noted in 30 (62.5%) and 21 (43.8%), respectively. Forty-four (91.7%) met criteria for acute pancreatitis during their index admission. Alcohol was the most common etiology (68.8%). No patient experienced organ failure. The most frequent imaging findings were fat stranding in the groove (83.3%), duodenal wall thickening (52.1%), and soft tissue mass/thickening in the groove (50%). Over a mean follow-up of 5.0 years, seven (14.6%) required a pancreas-related surgery. Patients had a high burden of pancreatitis-related readmissions (68.8%, 69.4/100 patient-years). Incident diabetes and chronic pancreatitis were diagnosed in 5 (13.9% of patients at risk) and 8 (29.6% of patients at risk) respectively. CONCLUSIONS: Groove pancreatitis has a wide spectrum of severity; most patients have mild disease. These patients have a high burden of readmissions and progression to chronic pancreatitis. A small minority requires surgical intervention.
BACKGROUND & AIMS: The natural history of groove pancreatitis is incompletely characterized. Published literature suggests a high rate of surgery. We describe the short- and long-term outcomes in a cohort of patients with groove pancreatitis treated at our institution. METHODS: Medical records of patients hospitalized in the University of Pittsburgh Medical Center system from 2000 to 2014 and diagnosed with groove pancreatitis based on imaging were retrospectively reviewed. Clinical presentation and outcomes during index admission and follow-up were recorded. RESULTS: Forty-eight patients with groove pancreatitis were identified (mean age 53.2 years, 79% male). Seventy-one percent were alcohol abusers and an equal number were cigarette smokers. Prior histories of acute and chronic pancreatitis were noted in 30 (62.5%) and 21 (43.8%), respectively. Forty-four (91.7%) met criteria for acute pancreatitis during their index admission. Alcohol was the most common etiology (68.8%). No patient experienced organ failure. The most frequent imaging findings were fat stranding in the groove (83.3%), duodenal wall thickening (52.1%), and soft tissue mass/thickening in the groove (50%). Over a mean follow-up of 5.0 years, seven (14.6%) required a pancreas-related surgery. Patients had a high burden of pancreatitis-related readmissions (68.8%, 69.4/100 patient-years). Incident diabetes and chronic pancreatitis were diagnosed in 5 (13.9% of patients at risk) and 8 (29.6% of patients at risk) respectively. CONCLUSIONS: Groove pancreatitis has a wide spectrum of severity; most patients have mild disease. These patients have a high burden of readmissions and progression to chronic pancreatitis. A small minority requires surgical intervention.
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