Cystic dystrophy of the duodenal wall is not always associated with chronic pancreatitis

Table 1 Epidemiological and clinical characteristics of patients in the 18 retrospective studies involving patients with a benign cystic duodenal wall

Author[Ref.] yr	Time interval of	n (%)			Age (yr)	Alcohol drinkers
	patient enrollment	Total	Males	Females	Mean (range)	n (%)
Stolte et al[7] 1982	NR	30	30 (100)	-	41.3 (NR)	22 (73.3)
Yamaguchi et al[10] 1992	1983-1989	8	8 (100)	-	58.0 (33-70)	4 (50.0)
Fléjou et al[11] 1993	1959-1991	10	10 (100)	-	41.0 (31-56)	2 (20.0)
Itoh et al[12] 1994	NR	4	3 (75.0)	1 (25.0)	43.0 (37-53)	NR
Fékété et al[13] 1996	1989-1993	6	6 (100)	-	40.0 (35-46)	4 (66.7)
Procacci et al[16] 1997	1992-1996	10	10 (100)	-	41.0 (32-59)	9 (90.0)
Irie et al[18] 1998	1995-1996	5	5 (100)	-	41.0 (33-46)	2 (40.0)
Vullierme et al[23] 2000	1988-1998	20	18 (90.0)	2 (10.0)	44.0 (36-56)	NR
Aoun et al[81] 2005	NR	4	2 (50.0)	2 (50.0)	69.0 (66-71)	NR
Pessaux et al[36] 2006	1990-2004	12	11 (91.7)	1 (8.3)	42.4 (34-54)	9 (75.0)
Jouannaud et al[37] 2006	1990-2002	23	20 (87.0)	3 (13.0)	45.0 (30-66)	23 (100)
Tison et al[39] 2007	1983-2001	9	8 (88.9)	1 (11.1)	48.0 (37-63)	8 (88.9)
Rebours et al[40] 2007	1995-2004	105	96 (91.4)	9 (8.6)	46.0 (24-75)	86 (81.9)
Rahman et al[46] 2007	2000-2005	11	10 (90.9)	1 (9.1)	48.0 (35-61)	10 (90.9)
Castell-Monsalve et al[47] 2008	NR	5	4 (80.0)	1 (20.0)	47.0 (40-53)	4 (80.0)
Jovanovic et al[52] 2008	1996-2006	13	10 (76.9)	3 (23.1)	41.5 (17-60)	6 (6.2)
Casetti et al[63] 2009	1990-2006	58	54 (93.1)	4 (6.9)	44.7 (IQR 36.8-51.8)	57 (98.3)
Ishigami et al[6] 2010	2001-2008	15	14 (93.3)	1 (6.7)	48.0 (31-64)	NR
Overall	-	348	319 (91.70)	29 (8.30)	-	246/305 (80.70)

IQR: Interquartile range; NR: Not reported.

Table 2 Epidemiological and clinical characteristics of patients in the 18 retrospective studies involving patients with a benign cystic duodenal wall (continues from Table 1) n (%)

Author[Ref.] yr	Time interval from the symptoms to the diagnosis	Abdominal pain		Weight loss	Jaundice	Hyperamylasemia
	Mean (range)	No. of cases	Type
Stolte et al[7] 1982	NR	NR	NR	30 (100)	NR	NR
Yamaguchi et al[10] 1992	NR	3 (37.5)	NR	0	2 (25.0)	NR
Fléjou et al[11] 1993	NR	7 (70.0)	Persistent	9 (90.0)	4 (40.0)	NR
Itoh et al[12] 1994	NR	3 (75.0)	NR	NR	NR	3 (75.0)
Fékété et al[13] 1996	NR	6 (100)	Recurrent	6 (100)	0	6 (100)
Procacci et al[16] 1997	4.5 yr (1-9)	10 (100)	Recurrent	4 (40.0)	1 (10.0)	NR
Irie et al[18] 1998	NR	4 (80.0)	NR	0	0	NR
Vullierme et al[23] 2000	41.5 d (1-140)	NR	NR	NR	NR	NR
Aoun et al[81] 2005	NR	3 (75.0)	NR	0	1 (25.0)	NR
Pessaux et al[36] 2006	NR	9 (75.0)	Persistent in 4 (44.4)	12 (100)	2 (16.7)	NR
Jouannaud et al[37] 2006	NR	22 (95.7)	NR	16 (69.6)	0	NR
Tison et al[39] 2007	NR	9 (100)	NR	9 (100)	2 (22.2)	NR
Rebours et al[40] 2007	1 yr (0-24)	91 (86.7)	Continuous in 35 (38.4); occasional in 56 (61.5)	73 (69.6)	13 (12.4)	NR
Rahman et al[46] 2007	NR	11 (100)	Recurrent in 8 (72.7)	10 (90.9)	0	2 (18.2)
Castell-Monsalve et al[47] 2008	NR	5 (100)	Persistent	NR	NR	5 (100)
Jovanovic et al[52] 2008	7.5 mo (0.5-36)	12 (92.3)	NR	4 (30.8)	4 (30.8)	NR
Casetti et al[63] 2009	NR	46 (79.3)	Persistent	NR	3 (5.2)	NR
Ishigami et al[6] 2010	NR	NR	NR	NR	NR	NR
Overall	-	241/283	-	173/246	32/274	16/26
		(85.20)		(70.30)	(11.70)	(61.50)

NR: Not reported.

Table 3 Epidemiological and clinical characteristics of patients in the 18 retrospective studies involving patients with a benign cystic duodenal wall (continues from Table 2) n (%)

Author[Ref.] yr	Imaging	Duodenal findings	CBD stenosis	Duodenal stenosis
Stolte et al[7] 1982	NR	Brunner hyperplasia in 25	15 (50.0)	NR
Yamaguchi et al[10] 1992	US, CT, ERCP, PTC	Edema and nodular appearance; Brunner hyperplasia	4 (50.0)	5 (62.5)
Fléjou et al[11] 1993	ERCP, EUS	Edema and congestion of the mucosa	0	7 (70.0)
Itoh et al[12] 1994	CT	NR	NR	NR
Fékété et al[13] 1996	CT, ERCP, EUS	Edema and congestion of the mucosa	0	5 (83.3)
Procacci et al[16] 1997	CT, ERCP, EUS	Inflammation in 8	2 (20.0)	2 (20.0)
Irie et al[18] 1998	MRI	Brunner hyperplasia in 3	2 (40.0)	3 (60.0)
Vullierme et al[23] 2000	CT	NR	3 (15.0)	20 (100)
Aoun et al[81] 2005	US, CT, ERCP, EUS	NR	4 (100)	NR
Pessaux et al[36] 2006	US, EUS, CT, ERCP, MRI	NR	NR	NR
Jouannaud et al[37] 2006	EUS, CT	Inflammation in 3	NR	8 (34.8)
Tison et al[39] 2007	US, CT, MRI, angiography	Non specific inflammation in 9	5 (55.6)	9 (100)
Rebours et al[40] 2007	CT, EUS	Brunner hyperplasia in 61	26 (24.8)	50 (47.6)
Rahman et al[46] 2007	CT, MRI, EUS	Brunner hyperplasia	0	5 (45.5)
Castell-Monsalve et al[47] 2008	MRI, EUS	Duodenal stenosis in 3	3 (60.0)	3 (60.0)
Jovanovic et al[52] 2008	US, CT, MRI, EUS	NR	6 (46.2)	NR
Casetti et al[63] 2009	US, CT, MRI, EUS	NR	3 (5.2)	NR
Ishigami et al[6] 2010	CT, MRI	NR	9 (60.0)	NR
Overall	-	-	82/309	117/212
			(26.50)	(55.20)

CBD: Common bile duct; NR: Not reported; US: Transabdominal ultrasonography; CT: Computer tomography; MRI: Magnetic resonance imaging; EUS: Endoscopic ultrasonography; ERCP: Endoscopic retrograde cholangiopancreatography; PTC: Percutaneous transhepatic cholangiography.

Table 4 Epidemiological and clinical characteristics of patients in the 18 retrospective studies involving patients with a benign cystic duodenal wall (continues from Table 3) n (%)

Author[Ref.] yr	Surgery		Associated chronic pancreatitis	Associated neoplasms	Pseudocyst	Follow-up
	No. of cases	Type				Mean (range)	Death	Lost
Stolte et al[7] 1982	30 (100)	PD	4 (13.3) (all with calcification)	No	5 (16.7)	NR	NR	NR
Yamaguchi et al[10] 1992	8 (100)	PD	NR	No	No	2 yr	1 (12.5)	NR
Fléjou et al[11] 1993	10 (100)	WP in 8;	0	No	No	1-5 yr	1 (10.0)	4 (40.0)
		derivative in 2
Itoh et al[12] 1994	3 (75.0)	PD	NR	No	No	No	NR	NR
Fékété et al[13] 1996	6 (100)	PD in 5;	NR	No	No	32 mo (18-64)	No	NR
		antrectomy in 1
Procacci et al[16] 1997	10 (100)	PD	7 (70.0) (calcifications in 5)	No	5 (head) (50.0)	NR	NR	NR
Irie et al[18] 1998	3 (60.0)	PD	2 (40.0) (all with calcifications)	No	No	NR	NR	NR
Vullierme et al[23] 2000	20 (100)	PD	9 (45.0)(calcifications in 5)	No	No	NR	NR	NR
Aoun et al[81] 2005	4 (100)	PD	NR	NR	NR	NR	NR	NR
Pessaux et al[36] 2006	12 (100)	PD	8 (66.7) (calcification in 2)	No	No	64 mo (6-158)	1 (8.3)	1 (8.3)
Jouannaud et al[37] 2006	14 (60.9)	PD in 11;	17 (73.9) (calcification in 10)	No	No	47 mo	1 (4.3)	NR
		derivative in 3
Tison et al[39] 2007	9 (100)	PD	5 (55.6)	No	No	72 mo	4 (44.4)	NR
Rebours et al[40] 2007	29 (27.6)	PD in 17; digestive and biliary by pass in 12	97 (92.4) (calcification in 96)	No	No	15 mo (0-243)	NR	NR
Rahman et al[46] 2007	11 (100)	PD	0	No	No	NR	NR	NR
Castell-Monsalve et al[47] 2008	4 (80.0)	WP in 3;	3 (60.0)	No	No	NR (13-36 mo)	No	NR
		1 laparotomy
Jovanovic et al[52] 2008	13 (100)	PD	6 (46.2)	No	No	NR	NR	NR
Casetti et al[63] 2009	58 (100)	PD	NR	Neuroendocrine in 1	No	93.6 mo	NR	NR
						(IQR 59.7-129.7)
Ishigami et al[6] 2010	6 (40.0)	PD in 3, derivative surgery in 3	NR	NR	NR	NR	NR	NR
Overall	250/348	-	158/253	1/329	10/329	-	8/73	5/22
	(71.8)		(62.5)	(0.3%)	(3.0)		(11.0)	(22.7)

IQR: Interquartile range; NR: Not reported; PD: Pancreaticoduodenectomy; WP: Whipple procedure.

Table 5 Epidemiological and clinical characteristics of patients in the 38 case report papers involving 46 subjects with a benign cystic duodenal wall (a paper may report more than one patient), the three cases reported in the present paper are also shown

Author[Ref.] yr	Gender	Age (yr)	Alcohol drinker
Bill et al[74] 1982	Male	64	Yes
Holstege et al[75] 1985	Male	44	Yes
Tio et al[9] 1991	Male	48	NR
Tio et al[9] 1991	Male	53	NR
Flaherty et al[75] 1992	Female	20 mo	No
Izbicki et al[77] 1994	Male	25	NR
Fujita et al[14] 1997	Male	42	Yes
Shudo et al[17] 1998	Male	66	Yes
Wu et al[78] 1998	Male	39	NR
Babál et al[79] 1998	Female	70	NR
Rubay et al[21] 1999	Male	46	Yes
Balachandar et al[22] 1999	Male	18	NR
Mohl et al[25] 2001	Male	44	Yes
Mohl et al[25] 2001	Male	42	Yes
Munthali Lovemore et al[26] 2001	Male	24	No
Indinnimeo et al [27] 2001	Male	46	Yes
Shudo et al[28] 2002	Male	53	Yes
Glaser et al[29] 2002	Male	51	Yes
Hwang et al[31] 2003	Male	46	Yes
Jovanovic et al[32] 2004	Male	38	No
McFaul et al[80] 2004	Male	29	Yes
McFaul et al[80] 2004	Male	62	Yes
Isayama et al[33] 2005	Male	56	Yes
Chatelain et al[34] 2005	Male	47	Yes
Chatelain et al[34] 2005	Female	44	Yes
Balzan et al[35] 2005	Male	47	NR
Sanada et al[43] 2007	Male	81	No
Balakrishnan et al[44] 2007	Male	40	Yes
de Tejada et al[50] 2008	Male	47	Yes
Stefanescu et al[51] 2008	Male	15	No
Varma et al[53] 2008	Female	23	NR
Galloro et al[54] 2008	Male	44	Yes
Thomas et al[59] 2009	Male	43	NR
Levenick et al[61] 2009	Female	35	Yes
Levenick et al[61] 2009	Male	47	Yes
Levenick et al[61] 2009	Female	36	Yes
Levenick et al[61] 2009	Female	54	NR
Yoshida et al[62] 2009	Male	63	Yes
Meesiri[64] 2009	Male	44	Yes
Funamizu et al[65] 2009	Female	54	NR
Viñolo Ubiña et al[66] 2010	Male	40	Yes
Tezuka et al[67] 2010	Male	55	Yes
Lee et al[69] 2010	Male	75	NR
Egorov et al[70] 2010	Male	32	Yes
Egorov et al[70] 2010	Male	43	NR
German et al[72] 2010	Male	34	Yes
Pezzilli2011 Present paper	Female	65	No
Pezzilli 2011 Present paper	Male	49	Yes
Pezzilli 2011 Present paper	Male	56	No
Overall	Males: 40 (81.6%)	45.3 ± 15.2	29/36
	Females: 9 (18.4%)		(80.50%)

NR: Not reported.

Table 6 Epidemiological and clinical characteristics of patients in the 38 case report papers involving 46 subjects with a benign cystic duodenal wall (a paper may report more than one patient), the three cases reported in the present paper are also shown (continues from Table 5)

Author[Ref.] yr	Time interval from the onset of symptoms to diagnosis	Abdominal pain	Weight loss	Jaundice	Hyperamylasemia
Bill et al[74] 1982	NR	Yes (Persistent)	Yes	No	No
Holstege et al[75] 1985	6 mo	Yes (Persistent)	Yes	No	Yes
Tio et al[9] 1991	NR	Yes (NR)	No	No	NR
Tio et al[9] 1991	NR	Yes (NR)	No	Yes	NR
Flaherty et al[75] 1992	NR	Yes (NR)	No	No	NR
Izbicki et al[77] 1994	NR	Yes (Recurrent)	No	No	No
Fujita et al[14] 1997	NR	Yes (Recurrent)	Yes	No	No
Shudo et al[17] 1998	NR	Yes (Persistent)	No	No	Yes
Wu et al[78] 1998	10 yr	Yes (Recurrent)	Yes	No	NR
Babál et al[79] 1998	NR	No	No	No	NR
Rubay et al[21] 1999	7 yr	Yes (Recurrent)	Yes	No	Yes
Balachandar et al[22] 1999	NR	No	No	Yes	No
Mohl et al[25] 2001	1 yr	Yes (Recurrent)	Yes	No	NR
Mohl et al[25] 2001	1 yr	Yes (Persistent)	Yes	No	NR
Munthali Lovemore et al[26] 2001	NR	Yes (Persistent)	NR	Yes	Yes
Indinnimeo et al[27] 2001	10 yr	Yes (Recurrent)	No	No	Yes
Shudo et al[28] 2002	NR	Yes (Persistent)	No	No	Yes
Glaser et al[29] 2002	NR	Yes (Persistent)	Yes	No	No
Hwang et al[31] 2003	NR	Yes (Persistent)	Yes	No	Yes
Jovanovic et al[32] 2004	NR	Yes (Persistent)	Yes	No	Yes
McFaul et al[80] 2004	13 mo	Yes (Recurrent)	Yes	No	NR
McFaul et al[80] 2004	2 yr	Yes (Recurrent)	Yes	Yes	NR
Isayama et al[33] 2005	2 yr	Yes (Persistent)	Yes	No	No
Chatelain et al[34] 2005	1 yr	Yes (Recurrent)	Yes	No	No
Chatelain et al[34] 2005	NR	Yes (Persistent)	Yes	No	No
Balzan et al[35] 2005	2 yr	Yes (Persistent)	No	No	Yes
Sanada et al[43] 2007	NR	Yes (Persistent)	No	No	Yes
Balakrishnan et al[44] 2007	NR	Yes (Persistent)	Yes	No	Yes
de Tejada et al[50] 2008	2 mo	Yes (Persistent)	Yes	No	NR
Stefanescu et al[51] 2008	5 mo	Yes (Persistent)	Yes	No	NR
Varma et al[53] 2008	3 mo	Yes (Persistent)	Yes	No	NR
Galloro et al[54] 2008	NR	Yes (Recurrent)	Yes	No	Yes
Thomas et al[59] 2009	NR	Yes (NR)	Yes	No	NR
Levenick et al[61] 2009	NR	Yes (Recurrent)	NR	No	NR
Levenick et al[61] 2009	NR	Yes (Recurrent)	Yes	No	NR
Levenick et al[61] 2009	NR	Yes (Recurrent)	Yes	No	NR
Levenick et al[61] 2009	NR	No	Yes	No	NR
Yoshida et al[62] 2009	NR	Yes (Persistent)	No	No	Yes
Meesiri[64] 2009	NR	Yes (Recurrent)	No	No	Yes
Funamizu et al[65] 2009	NR	Yes (Persistent)	No	Yes	Yes
Viñolo Ubiña et al[66] 2010	3 mo	Yes (Persistent)	No	No	Yes
Tezuka et al[67] 2010	NR	Yes (NR)	No	No	Yes
Lee et al[69] 2010	NR	Yes (Recurrent)	No	No	Yes
Egorov et al[70] 2010	2 mo	Yes (Persistent)	Yes	No	Yes
Egorov et al[70] 2010	1 yr	Yes (Persistent)	Yes	Yes	No
German et al[72] 2010	NR	Yes (Recurrent)	Yes	No	Yes
Pezzilli 2011 Present paper	1 yr	Yes (Recurrent)	Yes	Yes	No
Pezzilli 2011 Present paper	7 mo	Yes (Persistent)	Yes	No	Yes
Pezzilli 2011 Present paper	1 mo	Yes (Persistent)	Yes	Yes	Yes
Overall	2.1 ± 3.1 yr	46/49	30/47	8/49	22/33
		(93.90%)	(63.80%)	(16.30%)	(66.70%)

CBD: Common bile duct; NR: not reported.

Table 7 Epidemiological and clinical characteristics of patients in the 38 case report papers involving 46 subjects with a benign cystic duodenal wall (a paper may report more than one patient), the three cases reported in the present paper are also shown (continues from Table 6)

Author[Ref.] yr	Imaging	Duodenal findings	CBD stenosis	Duodenal stenosis
Bill et al[74] 1982	US, ERCP, angiography	NR	Yes	No
Holstege et al[75] 1985	US, CT, ERCP	Severe erosive gastritis + bulging of the duodenum	No	Yes
Tio et al[9] 1991	ERCP, EUS, US	Polypoid lesion	Yes	Yes
Tio et al[9] 1991	ERCP, EUS, US	NR	No	Yes
Flaherty et al[75] 1992	US	No	No	No
Izbicki et al[77] 1994	US, angiography, ERCP	NR	Yes	Yes
Fujita et al[14] 1997	US, CT, ERCP	Inflammation	No	Yes
Shudo et al[17] 1998	CT, US, ERCP, EUS, celiac angiography	Edema duodenal wall, Brunner hyperplasia	No	Yes
Wu et al[78] 1998	CT	NR	No	No
Babál et al[79] 1998	NR	NR	No	No
Rubay et al[21] 1999	CT, ERCP, MRI, EUS	No alterations	NR	Yes
Balachandar et al[22] 1999	CT, ERCP	No duodenal alteration	Yes	No
Mohl et al[25] 2001	CT	Stenosis	No	Yes
Mohl et al[25] 2001	US, CT, ERCP	Normal duodenal mucosa	No	No
Munthali Lovemore et al[26] 2001	US, CT, ERCP	NR	Yes	No
Indinnimeo et al[27] 2001	CT, MRI, EUS	No alterations	No	No
Shudo et al[28] 2002	CT, US, ERCP, EUS, celiac angiography	Irregular polypoid bulging; inflammation of the mucosa	NR	Yes
Glaser et al[29] 2002	US	Severe deformation + inflammatory changes	No	Yes
Hwang et al[31] 2003	US, CT, MRI	Duodenal inflammation, duodenal stenosis	NR	Yes
Jovanovic et al[32] 2004	US, CT, EUS, MRI	Stenosis	No	Yes
McFaul et al[80] 2004	US, CT, MRI	Brunner hyperplasia	Yes	Yes
McFaul et al[80] 2004	US, PET-CT	Brunner hyperplasia	No	No
Isayama et al[33] 2005	CT, EUS, MRCP, ERCP	NR	No	Yes
Chatelain et al[34] 2005	EUS, CT	Duodenal stenosis, inflammation	No	Yes
Chatelain et al[34] 2005	EUS, CT	Duodenal stenosis	No	Yes
Balzan et al[35] 2005	US, MRI, CT	NR	NR	NR
Sanada et al[43] 2007	CT, ERCP	Edema duodenal wall, Brunner hyperplasia	Yes	No
Balakrishnan et al[44] 2007	CT, ERCP, EUS	Edematous, shiny, reddish raise mucosa with polypoid appearance; Brunner hyperplasia	No	No
de Tejada et al[50] 2008	MRI, EUS	Bulging, Brunner hyperplasia	No	No
Stefanescu et al[51] 2008	CT, EUS	NR	No	Yes
Varma et al[53] 2008	US, CT	Brunner hyperplasia	No	No
Galloro et al[54] 2008	US, CT, EUS	Duodenal stenosis	No	Yes
Thomas et al[59] 2009	US, CT, EUS, octreotide scan	Brunner hyperplasia	No	Yes
Levenick et al[61] 2009	EUS, MRCP	Duodenal stenosis	No	Yes
Levenick et al[61] 2009	CT, EUS	Duodenal inflammation, duodenal stenosis	NR	Yes
Levenick et al[61] 2009	CT, EUS	Edema with acute and chronic inflammation	No	Yes
Levenick et al[61] 2009	CT, EUS, ERCP	NR	Yes	No
Yoshida et al[62] 2009	CT, MRCP	Normal mucosa	No	Yes
Meesiri[64] 2009	US, CT, MRI	Edema and hemorrhagic mucosa with inflammation	NR	No
Funamizu et al[65] 2009	ERCP, CT, angiography	NR	Yes	No
Viñolo Ubiñaet al[66] 2010	CT	Stenosis	NR	Yes
Tezuka et al[67] 2010	CT, ERCP	Edema duodenal wall	No	Yes
Lee et al[69] 2010	CT, MRCP	Active ulcer	Yes	No
Egorov et al[70] 2010	US, CT, EUS	Deformation, infiltration and ulcer; Inflammation	No	Yes
Egorov et al[70] 2010	US, CT, MRI, EUS	NR	Yes	Yes
German et al[72] 2010	US, CT, MRI	Edema duodenal wall; Brunner hyperplasia	Yes	Yes
Pezzilli 2011 Present paper	US, CT, EUS, ERCP	No	Yes	No
Pezzilli 2011 Present paper	US, CT, MRI	Hypertrophy of the Brunner glands	No	No
Pezzilli 2011 Present paper	US, CT	No	Yes	No
Overall	-	-	14/42	28/48
			(33.30%)	(58.30%)

CBD: Common bile duct; NR: Not reported; US: Transabdominal ultrasonography; CT: Computer tomography; MRI: Magnetic resonance imaging; EUS: Endoscopic ultrasonography; ERCP: Endoscopic retrograde cholangiopancreatography; MRCP: Magnetic resonance cholangiopancreatography; PET-CT: Positron emission tomography with associated computer tomography.

Table 8 Epidemiological and clinical characteristics of patients in the 38 case report papers involving 46 subjects with a benign cystic duodenal wall (a paper may report more than one patient), The three cases reported in the present paper are also shown (continues from Table 7)

Author[Ref.] yr	Surgery	Type of surgery	Endoscopic treatment	Associated chronic pancreatitis	Associated neoplasms	Pseudocyst	Follow-up	Death
Bill et al[74] 1982	Yes	PD	No	NR	No	No	No	NR
Holstege et al[75] 1985	Yes	WP	No	No	No	No	No	NR
Tio et al[9] 1991	No		No	No	No	No	7 yr	No
Tio et al[9] 1991	Yes	Derivative surgery	No	No	No	No	6 mo	NR
Flaherty et al[75] 1992	Yes	PD	No	No	No	No	9 mo	No
Izbicki et al[77] 1994	Yes	PD	No	No	No	No	6 yr	No
Fujita et al[14] 1997	Yes	PD	No	No	No	No	3 yr	No
Shudo et al[17] 1998	Yes	PD	No	No	No	No	NR	NR
Wu et al[78] 1998	Yes	WP	No	No	No	No	9 mo	No
Babál et al[79] 1998	No		No	No	No	No	NR	During hospitalization
Rubay et al[21] 1999	Yes	PD	No	No	No	No	2 mo	No
Balachandar et al[22] 1999	Yes	Derivative	No	Yes	No	No	NR	NR
Mohl et al[25] 2001	Yes	PD	No	No	No	No	No	NR
Mohl et al[25] 2001	Yes	PD	No	No	No	No	4 wk after surgery	No
Munthali Lovemore et al[26] 2001	Yes	Derivative CBD	No	No	No	No	No	NR
Indinnimeo et al[27] 2001	Yes	PD	No	No	No	No	2 yr	No
Shudo et al[28] 2002	Yes	PD	No	No	No	No	NR	NR
Glaser et al[29] 2002	No		No	No	No	No	No	NR
Hwang et al[31] 2003	No		No	No	No	No	NR	NR
Jovanovic et al[32] 2004	Yes	PD	No	No	No	No	No	NR
McFaul et al[80] 2004	Yes	PD	No	Yes	No	No	2 yr	No
McFaul et al[80] 2004	Yes	WP	No	Yes	No	No	NR	No
Isayama et al[33] 2005	No		Yes	No	No	No	12 mo	No
Chatelain et al[34] 2005	Yes	PD	No	No	No	No	6 mo	No
Chatelain et al[34] 2005	Yes	PD	No	No	No	No	12 mo	No
Balzan et al[35] 2005	Yes	PD	No	Yes	No	Yes (head)	No	NR
Sanada et al[43] 2007	Yes	PD	No	No	No	Yes (head)	No	NR
Balakrishnan et al[44] 2007	Yes	Laparotomy	No	Yes	No	No	NR	NR
de Tejada et al[50] 2008	Yes	WP	No	No	No	No	3 mo	No
Stefanescu et al[51] 2008	Yes	Derivative	No	No	No	No	8 mo	No
Varma et al[53] 2008	Yes	WP	No	No	No	No	9 mo	No
Galloro et al[54] 2008	Yes	WP	No	Yes	Cystadenoma	Yes	14 mo	No
				(with calcifications)
Thomas et al[59] 2009	Yes	PD	No	No	No	No	NR	NR
Levenick et al[61] 2009	Yes	PD	No	No	No	No	3 yr	No
Levenick et al[61] 2009	Yes	PD	No	Yes	No	No	NR	NR
Levenick et al[61] 2009	Yes	PD	No	No	No	No	NR	NR
Levenick et al[61] 2009	Yes	PD	No	No	No	No	NR	NR
Yoshida et al[62] 2009	Yes	PD	No	No	No	No	Yes (time NR)	No
Meesiri[64] 2009	No		No	No	No	No	Yes (time NR)	No
Funamizu et al[65] 2009	Yes	PD	No	No	Yes	No	15 mo	No
Viñolo Ubiña et al[66] 2010	Yes	PD	No	No	No	No	NR	No
Tezuka et al[67] 2010	Yes	PD	No	No	No	No	NR	No
Lee et al[69] 2010	No		No	No	No	No	NR	NR
Egorov et al[70] 2010	Yes	Pancreas-preserving duodenal resection	No	No	No	No	6 mo	No
Egorov et al[70] 2010	Yes	Pancreas-preserving duodenal resection	No	No	No	No	5 mo	No
German et al[72] 2010	Yes	PD	No	No	No	No	2 mo	NR
Pezzilli 2011 Present paper	No		Yes	No	No	No	20 mo	No
Pezzilli 2011 Present paper	Yes	PD	No	No	No	No	7 mo	No
Pezzilli 2011 Present paper	Yes	PD	No	Autoimmune pancreatitis	Yes	No	4 mo	No
Overall	41/49	-	2/49	8/48	3/49	3/49	17.9 ± 20.6 mo	1/28
	(83.70%)		(4.10%)	(16.70%)	(6.10%)	(6.10%)		(3.60%)

CBD: Common bile duct; NR: Not reported; PD: Pancreaticoduodenectomy; WP: Whipple procedure.

Table 9 Epidemiological and clinical characteristics of patients in the two retrospective studies and two case report papers involving two subjects with groove adenocarcinoma

Author[Ref.] yr	Type of study	Time interval of patient enrollment	No. of patients			Age (yr)	Alcohol drinkers
			Total	Males	Females	Mean (range)
Suehara et al[20] 1998	Case report	1995	1	1	-	61	Yes
Gabata et al[30] 2003	Retrospective	1998-2001	9	4 (44.4%)	5 (55.6%)	72 (56-87)	NR
Tan et al[38] 2006	Case report	NR	1	-	1	69	NR
Ishigami et al[6] 2010	Retrospective	2001-2008	7	6 (85.7%)	1 (14.3%)	70 (57-80)	NR

NR: Not reported.

Table 10 Epidemiological and clinical characteristics of patients in the two retrospective studies and two case report papers involving two subjects with groove adenocarcinoma (continues from Table 9)

Author[Ref.] yr	Abdominal pain	Weight loss	Jaundice	Hyperamylasemia
Suehara et al[20] 1998	Yes (Persistent)	No	Yes	Yes
Gabata et al[30] 2003	NR	NR	NR	NR
Tan et al[38] 2006	Yes (Persistent)	Yes	Yes	Yes
Ishigami et al[6] 2010	NR	NR	NR	NR

NR: Not reported.

Table 11 Epidemiological and clinical characteristics of patients in the two retrospective studies and two case report papers involving two subjects with groove adenocarcinoma (continues from Table 10)

Author[Ref.] yr	Imaging	Duodenal findings	CBD stenosis	Duodenal stenosis
Suehara et al[20] 1998	US, EUS, CT, MRI, angiography	NR	Yes	No
Gabata et al[30] 2003	CT, RMI, ERCP, angiography	Edema with erosions	9 (100%)	9 (100%)
Tan et al[38] 2006	US, MRI, ERCP	NR	Yes	No
Ishigami et al[6] 2010	CT, MRI	NR	7 (100%)	NR

CBD: Common bile duct; NR: Not reported; US: Transabdominal ultrasonography; CT: Computer tomography; MRI: Magnetic resonance imaging; EUS: Endoscopic ultrasonography; ERCP: Endoscopic retrograde cholangiopancreatography.

Table 12 Epidemiological and clinical characteristics of patients in the two retrospective studies and two case report papers involving two subjects with groove adenocarcinoma (continues from Table 11)

Author[Ref.] yr	Surgery		Associated chronic pancreatitis	Pseudocyst	Follow-up
	No. of cases	Type
Suehara et al[20] 1998	Yes	PD	No	No	NR
Gabata et al[30] 2003	9 (100%)	PD in 7; derivative in 2	No	No	NR
Tan et al[38] 2006	Yes	By-pass surgery	No	No	NR
Ishigami et al[6] 2010	6 (85.7%)	PD in 5; derivative in 1	No	NR	NR

NR: Not reported; PD: Pancreaticoduodenectomy.