T Tarvainen1, T Nykänen2, H Parviainen3, J Kuronen3, L Kylänpää1, J Sirén1, A Kokkola1, V Sallinen4. 1. Gastroenterological Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. 2. Gastroenterological Surgery, Hyvinkää Hospital, Hyvinkää, Finland. 3. Medical Imaging Center, Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. 4. Gastroenterological Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Transplantation and Liver Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. Electronic address: ville.sallinen@helsinki.fi.
Abstract
BACKGROUND: Groove pancreatitis (GP) is a rare form of chronic pancreatitis with limited data on its diagnostics and treatment outcomes. The aim of this study was to assess its diagnostics, natural course, and treatment options. METHODS: The study is a retrospective population-based study from Southern Finland, including all patients with suspected GP between January 2005 and December 2015. Two certified gastrointestinal radiologists re-reviewed the imaging studies. The radiological re-review, clinical judgment, and final histopathology confirmed the GP diagnoses. RESULTS: Out of 67 patients with possible GP, 39 patients were considered to have high radiological certainty of GP. Out of these 39, five patients had cancer instead. Thirty-three patients with confirmed GP formed the final study cohort. Patients with GP were mostly middle-aged (median 55 years) men. All had at least moderate alcohol consumption. No intervention was needed in 14 patients. In five-year follow-up all conservatively treated patients became asymptomatic, while 10 out of 16 patients undergoing at least one intervention were asymptomatic at five years. CONCLUSION: The radiological diagnosis of GP is difficult, and a low threshold for cancer suspicion should be kept. Symptoms of GP decrease with time and suggest conservative treatment as the first-line option.
BACKGROUND: Groove pancreatitis (GP) is a rare form of chronic pancreatitis with limited data on its diagnostics and treatment outcomes. The aim of this study was to assess its diagnostics, natural course, and treatment options. METHODS: The study is a retrospective population-based study from Southern Finland, including all patients with suspected GP between January 2005 and December 2015. Two certified gastrointestinal radiologists re-reviewed the imaging studies. The radiological re-review, clinical judgment, and final histopathology confirmed the GP diagnoses. RESULTS: Out of 67 patients with possible GP, 39 patients were considered to have high radiological certainty of GP. Out of these 39, five patients had cancer instead. Thirty-three patients with confirmed GP formed the final study cohort. Patients with GP were mostly middle-aged (median 55 years) men. All had at least moderate alcohol consumption. No intervention was needed in 14 patients. In five-year follow-up all conservatively treated patients became asymptomatic, while 10 out of 16 patients undergoing at least one intervention were asymptomatic at five years. CONCLUSION: The radiological diagnosis of GP is difficult, and a low threshold for cancer suspicion should be kept. Symptoms of GP decrease with time and suggest conservative treatment as the first-line option.
Authors: Belén Matías-García; Camilo José Castellón-Pavón; Gustavo Díaz-García; Belén Manso-Abajo; Daniel Hernández-Aceituno; Antonio Hermosín-Peña; Luis Mejías-Sosa; Manuel Durán-Poveda Journal: Case Rep Surg Date: 2022-03-07