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“Paraduodenal” Pancreatitis: Results of Surgery on 58 Consecutives Patients from a Single Institution

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Abstract

Background

Cystic dystrophy of heterotopic pancreas, groove pancreatitis, pancreatic hamartoma of the duodenum, paraduodenal wall cyst, and myoadenomatosis are all terms grouped together, from a pathological viewpoint, as definitions of paraduodenal pancreatitis (PP). The objective of the present study was to investigate the clinical characteristics, therapeutic strategies, and results in 58 patients undergoing pancreatic resection for PP.

Methods

From January 1990 to December 2006 data were prospectively collected on 58 patients who were diagnosed with PP who then underwent pancreaticoduodenectomy.

Results

In this patient cohort the median age was 44.7 years; only 4 patients were women, and only 3 had non-drinker and/or non smoker habits. The overall morbidity was 18.9%, and the median hospitalization was 11 days. There were no postoperative deaths. In a median follow-up of 96.3 months, all patients noted a decrease in the pain associated with PP; 35 patients (76%) had complete disappearance of pain, whereas occasional relapsing pain occurred in the remaining 11 (24%).

Conclusions

Patients with PP have clinical characteristics similar to those of chronic pancreatitis. The diagnostic imaging modalities of choice are ultrasonographic endoscopy and magnetic resonance cholangiopancreaticography. Based on our surgical experience, pancreaticoduodenectomy seems to be a reasonable choice of treatment in patients with PP.

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References

  1. Adsay NV, Zamboni G (2004) Paraduodenal pancreatitis: a clinico-pathologically distinct entity unifying “cystic dystrophy of heterotopic pancreas”, “para-duodenal wall cyst”, and “groove pancreatitis”. Semin Diagn Pathol 21:247–254

    Article  CAS  PubMed  Google Scholar 

  2. Potet F, Duclert N (1970) Cystic dystrophy on aberrant pancreas of the duodenal wall. Arch Fr Mal App Dig 59:223–238

    CAS  PubMed  Google Scholar 

  3. Flejou JF, Potet F, Molas G et al (1993) Cystic dystrophy of the gastric and duodenal wall developing in heterotopic pancreas: an unrecognised entity. Gut 34:343–347

    Article  CAS  PubMed  Google Scholar 

  4. Visset J, Jais F, Le Bodic MF et al (1992) Cystic dystrophy of aberrant pancreatic tissue in the duodenal wall. Diagnostic and therapeutic problems. Chirurgie 118:634–636

    CAS  PubMed  Google Scholar 

  5. Hebrero J, Diego Estevez M, Martinez Arrieta F et al (1980) Cystic dystrophy in pancreatic heterotopia of the duodenal wall. Rev Esp Enferm Apar Dig 57:51–56

    CAS  PubMed  Google Scholar 

  6. Vullierme MP, Vilgrain V, Flejou JF et al (2000) Cystic dystrophy of the duodenal wall in the heterotopic pancreas: radiopathological correlations. J Comput Assist Tomogr 24:635–643

    Article  CAS  PubMed  Google Scholar 

  7. Chatelain D, Vibert E, Yzet T et al (2005) Groove pancreatitis and pancreatic heterotopia in the minor duodenal papilla. Pancreas 30:e92–e95

    Article  PubMed  Google Scholar 

  8. Becker V, Mischke U (1991) Groove pancreatitis. Int J Pancreatol 10:173–182

    CAS  PubMed  Google Scholar 

  9. Scapa E, Broide E, Halevy A et al (1994) Groove pancreatitis and adenocarcinoma of the pancreatic head. Harefuah 127:161–162, 215

    Google Scholar 

  10. Fujita N, Shirai Y, Tsukada K et al (1997) Groove pancreatitis with recurrent duodenal obstruction. Report of a case successfully treated with pylorus-preserving pancreaticoduodenectomy. Int J Pancreatol 21:185–188

    CAS  PubMed  Google Scholar 

  11. Wu SS, Vargas HI, French SW (1998) Pancreatic hamartoma with Langerhans cell histiocytosis in a draining lymph node. Histopathology 33:485–487

    Article  CAS  PubMed  Google Scholar 

  12. McFaul CD, Vitone LJ, Campbell F et al (2004) Pancreatic hamartoma. Pancreatology 4:533–537; discussion 537–538

    Article  CAS  PubMed  Google Scholar 

  13. Noltenius H, Colmant HJ (1977) Excessive hyperplasia of the exocrine pancreatic tissue and Wernicke’s encephalopathy (author’s transl). Med Klin 72:2155–2158

    CAS  PubMed  Google Scholar 

  14. Izbicki JR, Knoefel WT, Muller-Hocker J et al (1994) Pancreatic hamartoma: a benign tumor of the pancreas. Am J Gastroenterol 89:1261–1262

    CAS  PubMed  Google Scholar 

  15. Stolte M, Zink W, Schaffner O (1983) Duodenal wall cysts and diseases of the pancreas. Leber Magen Darm 13:140–149

    CAS  PubMed  Google Scholar 

  16. Holstege A, Barner S, Brambs HJ et al (1985) Relapsing pancreatitis associated with duodenal wall cysts. Diagnostic approach and treatment. Gastroenterology 88:814–819

    CAS  PubMed  Google Scholar 

  17. Seitz K, Rettenmaier G, Stolte M (1985) Groove pancreatitis—its pathological anatomy and sonographic findings. Ultraschall Med 6:131–133

    Article  CAS  PubMed  Google Scholar 

  18. Suda K, Takase M, Shiono S et al (2002) Duodenal wall cysts may be derived from a ductal component of ectopic pancreatic tissue. Histopathology 41:351–356

    Article  CAS  PubMed  Google Scholar 

  19. Bill K, Belber JP, Carson JW (1982) Adenomyoma (pancreatic heterotopia) of the duodenum producing common bile duct obstruction. Gastrointest Endosc 28:182–184

    Article  CAS  PubMed  Google Scholar 

  20. Aoun N, Zafatayeff S, Smayra T et al (2005) Adenomyoma of the ampullary region: imaging findings in four patients. Abdom Imaging 30:86–89

    Article  CAS  PubMed  Google Scholar 

  21. Parc R, Soprani A, Louvel A (1977) Heterotopic cystic pancreas of the duodenal wall without associated chronic pancreatitis (author’s transl). J Chir (Paris) 114:185–192

    CAS  Google Scholar 

  22. Ozeki Y, Onitsuka A, Hayashi M et al (1991) Idiopathic duodenal obstruction resembling pure groove pancreatitis: a case report. Nippon Shokakibyo Gakkai Zasshi 88:1140–1144

    CAS  PubMed  Google Scholar 

  23. Shudo R, Obara T, Tanno S et al (1998) Segmental groove pancreatitis accompanied by protein plugs in Santorini’s duct. J Gastroenterol 33:289–294

    Article  CAS  PubMed  Google Scholar 

  24. Prandi D, Maillard JN, Potet F (1972) Surgical treatment of cystic dystrophy on aberrant pancreas of the duodenal wall (apropos of 3 cases). Arch Fr Mal App Dig 61:193–198

    CAS  PubMed  Google Scholar 

  25. Tio TL, Luiken GJ, Tytgat GN (1991) Endosonography of groove pancreatitis. Endoscopy 23:291–293

    Article  CAS  PubMed  Google Scholar 

  26. Falconi M, Valerio A, Caldiron E et al (2000) Changes in pancreatic resection for chronic pancreatitis over 28 years in a single institution. Br J Surg 87:428–433

    Article  CAS  PubMed  Google Scholar 

  27. Beger HG, Schlosser W, Friess HM et al (1999) Duodenum-preserving head resection in chronic pancreatitis changes the natural course of the disease: a single-center 26-year experience. Ann Surg 230:512–519; discussion 519–523

    Article  CAS  PubMed  Google Scholar 

  28. Tison C, Leborgne J (2001) Cystic dystrophy of heterotopic duodenal pancreas. J Chir (Paris) 138:205–214

    CAS  Google Scholar 

  29. Marmorale A, Tercier S, Peroux JL et al (2003) Cystic dystrophy in heterotopic pancreas of the second part of the duodenum. One case of conservative surgical procedure. Ann Chir 128:180–184

    Article  CAS  PubMed  Google Scholar 

  30. Glaser M, Roskar Z, Skalicky M et al (2002) Cystic dystrophy of the duodenal wall in a heterotopic pancreas. Wien Klin Wochenschr 114:1013–1016

    PubMed  Google Scholar 

  31. Bittar I, Cohen Solal JL et al (2000) Cystic dystrophy of an aberrant pancreas. Surgery after failure of medical therapy. Presse Med 29:1118–1120

    CAS  PubMed  Google Scholar 

  32. Desrame J, Minvielle F, Thiolet C et al (2000) Cystic dystrophia of the duodenal wall with aberrant pancreas. Value of magnetic resonance imaging for diagnosis. Presse Med 29:1759–1761

    CAS  PubMed  Google Scholar 

  33. Rey P, Carrere C, Tissier S et al (2003) Groove pancreatitis. Diagnostic impact of dynamic radiology. Presse Med 32:1705–1706

    PubMed  Google Scholar 

  34. Gabata T, Kadoya M, Terayama N et al (2003) Groove pancreatic carcinomas: radiological and pathological findings. Eur Radiol 13:1679–1684

    Article  PubMed  Google Scholar 

  35. Regent D, Laurent V, Antunes L et al (2002) Fibrous tissue(s): a key for lesion characterization in digestive diseases. J Radiol 83(2 Pt 2):292–312

    CAS  PubMed  Google Scholar 

  36. Ito K, Koike S, Matsunaga N (2001) MR imaging of pancreatic diseases. Eur J Radiol 38:78–93

    Article  CAS  PubMed  Google Scholar 

  37. Irie H, Honda H, Kuroiwa T et al (1998) MRI of groove pancreatitis. J Comput Assist Tomogr 22:651–655

    Article  CAS  PubMed  Google Scholar 

  38. Procacci C, Graziani R, Zamboni G et al (1997) Cystic dystrophy of the duodenal wall: radiologic findings. Radiology 205:741–747

    CAS  PubMed  Google Scholar 

  39. Hwang JY, Park KS, Cho KB et al (2003) Segmental groove pancreatitis: report of one case. Korean J Intern Med 18:234–237

    PubMed  Google Scholar 

  40. Basili E, Allemand I, Ville E et al (2001) Lanreotide acetate may cure cystic dystrophy in heterotopic pancreas of the duodenal wall. Gastroenterol Clin Biol 25:1108–1111

    CAS  PubMed  Google Scholar 

  41. Arisaka Y, Tada H, Hongoh Y et al (1998) A case of groove pancreatitis successfully treated with conservative therapy. Nippon Shokakibyo Gakkai Zasshi 95:1157–1161

    CAS  PubMed  Google Scholar 

  42. de Parades V, Roulot D, Palazzo L et al (1996) Treatment with octreotide of stenosing cystic dystrophy on heterotopic pancreas of the duodenal wall. Gastroenterol Clin Biol 20:601–604

    PubMed  Google Scholar 

  43. Pessaux P, Lada P, Etienne S et al (2006) Duodenopancreatectomy for cystic dystrophy in heterotopic pancreas of the duodenal wall. Gastroenterol Clin Biol 30:24–28

    Article  PubMed  Google Scholar 

  44. Isayama H, Kawabe T, Komatsu Y et al (2005) Successful treatment for groove pancreatitis by endoscopic drainage via the minor papilla. Gastrointest Endosc 61:175–178

    Article  PubMed  Google Scholar 

  45. Beaulieu S, Vitte RL, Le Corguille M et al (2004) Endoscopic drainage of cystic dystrophy of the duodenal wall: report of three cases. Gastroenterol Clin Biol 28:1159–1164

    PubMed  Google Scholar 

  46. Fekete F, Noun R, Sauvanet A et al (1996) Pseudotumor developing in heterotopic pancreas. World J Surg 20:295–298

    Article  CAS  PubMed  Google Scholar 

  47. Munthali Lovemore CE, Hsu JT, Chiu CT et al (2001) Groove pancreatitis: case report and literature review. Chang Gung Med J 24:512–516

    CAS  PubMed  Google Scholar 

  48. Di Sebastiano P, di Mola FF, Buchler MW et al (2004) Pathogenesis of pain in chronic pancreatitis. Dig Dis 22:267–272

    Article  PubMed  Google Scholar 

  49. Bassi C, Falconi M, Molinari E et al (2005) Reconstruction by pancreaticojejunostomy versus pancreaticogastrostomy following pancreatectomy: results of a comparative study. Ann Surg 242:767–771; discussion 771–763

    Article  PubMed  Google Scholar 

  50. Bassi C, Falconi M, Molinari E et al (2003) Duct-to-mucosa versus end-to-side pancreaticojejunostomy reconstruction after pancreaticoduodenectomy: results of a prospective randomized trial. Surgery 134:766–771

    Article  PubMed  Google Scholar 

  51. Bassi C, Falconi M, Salvia R et al (2001) Management of complications after pancreaticoduodenectomy in a high volume centre: results on 150 consecutive patients. Dig Surg 18:453–457; discussion 458

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

This work was supported by the Fondazione Cariverona 20, Ministero Univarsità e Ricerca Scientifica 200560715-004, Rome, and the Fondazione Italiana per la Ricerca sulle Malattie del Pancreas (FIMP).

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Authors and Affiliations

  1. Dipartimento di Scienze Chirurgiche, University of Verona, Policlinico G. B. Rossi, Piazzale L.A. Scuro, 37134, Verona, Italy

    L. Casetti, C. Bassi, R. Salvia, G. Butturini, M. Falconi, L. Frulloni, S. Crippa & P. Pederzoli

  2. Department of Radiology, University of Verona, Verona, Italy

    R. Graziani

  3. Department of Pathology, University of Verona, Verona, Italy

    G. Zamboni

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  1. L. Casetti
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  2. C. Bassi
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  3. R. Salvia
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  4. G. Butturini
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  5. R. Graziani
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  6. M. Falconi
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  7. L. Frulloni
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  8. S. Crippa
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  9. G. Zamboni
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  10. P. Pederzoli
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Correspondence to C. Bassi.

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Casetti, L., Bassi, C., Salvia, R. et al. “Paraduodenal” Pancreatitis: Results of Surgery on 58 Consecutives Patients from a Single Institution. World J Surg 33, 2664–2669 (2009). https://doi.org/10.1007/s00268-009-0238-5

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