• Bbiliary strictures
• Endoscopic treatment of biliary stricture
• pancreatitis

• chronic pancreatitis
• groove carcinoma
• groove pancreatitis
• tumor-like

• Chronic pancreatitis
• Groove pancreatitis
• Inflammation
• Pancreas
• Paraduodenal pancreatitis

• Diagnosis
• Etiology
• Groove
• Management
• Pancreatitis
• Pathogenesis

• Humans
• Risk Factors
• Pancreatitis, Chronic/diagnosis
• Pancreatitis, Chronic/etiology
• Pancreatitis, Chronic/therapy
• Male
• Female
• Artificial Intelligence
• Diagnosis, Differential
• Pancreas/pathology
• Pancreas/diagnostic imaging
• Pancreatic Neoplasms/diagnosis
• Pancreatic Neoplasms/etiology
• Pancreatic Neoplasms/therapy
• Sex Factors
• Prevalence

• Humans
• Pancreatitis/diagnosis
• Pancreatitis/etiology

• chronic pancreatitis
• groove pancreatitis
• renal dysfunction
• upper gastrointestinal obstruction

• chronic pancreatitis
• diagnostic imaging
• groove pancreatitis
• paraduodenal pancreatitis
• step-up approach

• arterial abnormality
• groove pancreatitits
• pancreatoduodenectomy
• severe fibrosis
• smoking

• Humans
• Pancreaticoduodenectomy/methods
• Aged
• Female
• Tomography, X-Ray Computed
• Pancreatitis, Chronic/surgery
• Pancreatitis/surgery
• Pancreas/abnormalities
• Pancreas/diagnostic imaging
• Pancreas/surgery

• Computerized tomography
• endoscopic ultrasound
• groove pancreatitis
• magnetic resonance imaging

• Middle Aged
• Humans
• Male
• Endosonography
• Pancreatitis, Chronic/diagnostic imaging
• Biopsy

• Groove pancreatitis
• Pancreatoduodenectomy
• Paraduodenal pancreatitis

• Humans
• Male
• Middle Aged
• Female
• Rare Diseases
• Abdominal Pain/etiology
• Case-Control Studies
• Conservative Treatment
• Pancreatitis/diagnostic imaging
• Pancreatitis/therapy

• Cystic dystrophy in heterotopic pancreas
• Duodenal resection with pancreatic preservation
• Pancreatic cyst
• Paraduodenal pancreatitis
• pancreaticoduodenectomy

Paraduodenal pancreatitis (PP) represents a diagnostic challenge, especially in non-referral centers, given its potential imaging overlap with pancreatic cancer. There are two main histological variants of PP, the cystic and the solid, with slightly different imaging appearances. Moreover, imaging findings in PP may change over time because of disease progression and/or as an effect of its risk factors exposition, namely alcohol intake and smoking.

To describe multimodality imaging findings in patients affected by PP to help clinicians in the differential diagnosis with pancreatic cancer.

The systematic review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-analyses 2009 guidelines. A Literature search was performed on PubMed, Embase and Cochrane Library using (groove pancreatitis [Title/Abstract]) OR (PP [Title/Abstract]) as key words. A total of 593 articles were considered for inclusion. After eliminating duplicates, and title and abstract screening, 53 full-text articles were assessed for eligibility. Eligibility criteria were: Original studies including 8 or more patients, fully written in English, describing imaging findings in PP, with pathological confirmation or clinical-radiological follow-up as the gold standard. Finally, 14 studies were included in our systematic review.

Computed tomography (CT) findings were described in 292 patients, magnetic resonance imaging (MRI) findings in 231 and endoscopic ultrasound (EUS) findings in 115. Duodenal wall thickening was observed in 88.8% of the cases: Detection rate was 96.5% at EUS, 91.0% at MRI and 84.1% at CT. Second duodenal portion increased enhancement was recognizable in 76.3% of the cases: Detection rate was 84.4% at MRI and 72.1% at CT. Cysts within the duodenal wall were detected in 82.6% of the cases: Detection rate was 94.4% at EUS, 81.9% at MRI and 75.7% at CT. A solid mass in the groove region was described in 40.9% of the cases; in 78.3% of the cases, it showed patchy enhancement in the portal venous phase, and in 100% appeared iso/hyperintense during delayed phase imaging. Only 3.6% of the lesions showed restricted diffusion. The prevalence of radiological signs of chronic obstructive pancreatitis, namely main pancreatic duct dilatation, pancreatic calcifications, and pancreatic cysts, was extremely variable in the different articles.

PP has peculiar imaging findings. MRI is the best radiological imaging modality for diagnosing PP, but EUS is more accurate than MRI in depicting duodenal wall alterations.

• Pancreatitis
• Paraduodenal pancreatitis
• Diagnostic imaging
• Computed tomography
• Magnetic resonance imaging
• Endoscopic ultrasound

• EUS-FNA
• groove pancreatitis

• Chronic pancreatitis
• Classification
• Complications
• Pathophysiology
• Surgical treatment

Groove pancreatitis (GP) is an underrecognised subtype of chronic pancreatitis, focally affecting the area between the duodenum and pancreatic head. It most commonly affects males between 40 and 50 years of age with a history of alcohol misuse. Patients most commonly complain of abdominal pain and vomiting. Due to its focal nature, it is a potentially surgically treatable form of chronic pancreatitis. We report results of patients surgically treated for groove pancreatitis followed by a literature review of patient outcomes post resection.

A retrospective chart review of patients with histopathologically confirmed GP post‐surgical resection at the Princess Alexandra Hospital and Greenslopes Private Hospital in Brisbane, Australia was conducted between 2013 and 2020. Diagnosis was confirmed histologically when Brunner gland hyperplasia and chronic inflammation/fibrosis were found within the pancreaticoduodenal interface. Preoperative and postoperative symptoms were analysed along with complications. Additionally, a systematic review on outcomes of patients undergoing pancreaticoduodenectomy (PD) for GP was performed from three databases.

Eight patients underwent surgery for GP. Elimination of preoperative symptoms was achieved in five of the eight patients. Major complications included one take back to theatre for pancreatic leak. Our literature review found complete resolution of pain and vomiting in 80% of GP patients after PD.

Optimal management of GP begins with early recognition. Symptoms from GP are likely to respond well to surgical intervention. We advocate for aggressive surgical resection in a patient with a high index of suspicion for GP.

• groove
• pancreaticoduodenectomy
• pancreatitis
• paraduodenal
• whipples

• Groove pancreatitis
• Outcome
• Pancreaticoduodenectomy
• Surgery

• Paraduodenal pancreatitis
• cystic dystrophy of heterotopic pancreas
• duodenal dystrophy
• groove pancreatitis
• paraduodenal wall cyst

• Choristoma
• Female
• Humans
• Male
• Middle Aged
• Pancreas/diagnostic imaging
• Pancreas/pathology
• Pancreatitis/diagnosis
• Prospective Studies
• Retrospective Studies
• Tomography, X-Ray Computed

Paraduodenal pancreatitis (PP) is a rare type of focal pancreatitis involving the groove space. It mimics pancreatic head carcinoma, and its diagnosis and treatment are challenging. Pancreatoduodenectomy (PD) has traditionally been the primary surgical treatment for duodenal stenosis or suspected cancer.

We herein report a case of PP in a 65-year-old man. The patient was admitted to the hospital for postprandial epigastric pain and vomiting. A low-density mass between the uncinate process of the pancreas and the horizontal segment of the duodenum was suspected based on computed tomography findings. Both upper gastrointestinal radiography and gastrointestinal endoscopy showed an obstruction of the distal part of the descending duodenum. An operation was performed to release the obstruction and obtain a definitive diagnosis. A 3-cm mass in the groove area was compressing the third part of the duodenum, and PD was empirically performed. The final histopathological diagnosis was PP. Postoperatively, the patient developed anastomotic leakage of the gastrojejunostomy site with bleeding and was eventually discharged on postoperative day 51 after emergency surgery.

PP should be considered as a differential diagnosis of pancreatic ductal adenocarcinoma or duodenal stenosis, and accurate preoperative diagnosis preserves the opportunity for conservative or endoscopic management.

• Paraduodenal pancreatitis
• case report
• duodenal stenosis
• gastrointestinal anastomotic leakage
• pancreatic ductal adenocarcinoma
• pancreaticoduodenectomy

• Acute pancreatitis
• Chronic pancreatitis
• Groove pancreatitis
• Paraduodenal pancreatitis

• Adult
• Aged
• Aged, 80 and over
• Alcoholism/complications
• Cigarette Smoking/adverse effects
• Cohort Studies
• Female
• Humans
• Male
• Middle Aged
• Pancreatitis/classification
• Pancreatitis/diagnostic imaging
• Pancreatitis/pathology
• Pancreatitis/therapy
• Retrospective Studies
• Risk Factors

• R01 DK077906 NIDDK NIH HHS
• T32 DK063922 NIDDK NIH HHS
• U01 DK108306 NIDDK NIH HHS

Groove pancreatitis (GP) is a rare form of chronic pancreatitis involving the groove area bound by the pancreatic head, the duodenum, and the common bile duct. The diagnosis of this entity is challenging since it can mimic pancreatic carcinoma. We herein report the case of groove pancreatitis diagnosed in a 37 year old men, with a past history of chronic alcohol consumption. The patient was admitted for several times over the past three years because of recurrent alcohol-induced pancreatitis. The diagnosis of groove pancreatitis was made on the basis of CT, MRI and EUS findings. A medical treatment was initially attempted. In the absence of improvement in clinical symptoms, a pancreatico-duodenectomy was performed with satisfying results at 24 months follow up. Pancreatico-duodenectomy is the treatment of choice in groove pancreatitis since it leads to total resolution of clinical symptoms.

• Chronic pancreatitis
• pancreas disease
• pancreatico-duodenectomy
• surgical management

• Endoscopic treatment
• Groove pancreatitis
• Pancreatic ducts
• Paraduodenal pancreatitis

• Cholangiopancreatography, Endoscopic Retrograde/instrumentation
• Cholangiopancreatography, Endoscopic Retrograde/methods
• Dilatation/methods
• Drainage/methods
• Duodenum/pathology
• Duodenum/physiopathology
• Feasibility Studies
• Female
• Humans
• Male
• Middle Aged
• Pancreas/diagnostic imaging
• Pancreatic Ducts/diagnostic imaging
• Pancreatic Ducts/surgery
• Pancreatitis, Chronic/diagnosis
• Pancreatitis, Chronic/physiopathology
• Pancreatitis, Chronic/surgery
• Stents
• Tomography, X-Ray Computed/methods
• Treatment Outcome

• Chronic abdominal pain
• Duodenal obstruction
• Pancreaticoduodenectomy
• Pancreatitis
• Somatostatin

Groove pancreatitis (GP) is a rare type of chronic pancreatitis, which primarily affects the groove area of the pancreatic head. Surgery is considered as the ultimate method for GP if the symptoms are not improved by conservative or endoscopic treatments, and the Whipple technique is the common choice at present. The present study introduces a novel surgical procedure for GP, namely groove resection of pancreatic head (GRPH), in a 56-year-old male patient. To the best of our knowledge, this is the first report on GRPH for the surgical treatment of GP. This patient was diagnosed with typical GP without any evidence of malignancy, based on imaging studies and gastrointestinal endoscopy, and was treated with GRPH. Briefly, only the groove area of the pancreatic head was resected, while the duodenum, the main pancreatic duct and the majority of the pancreatic head were preserved. A complete relief of abdominal pain and a weight gain were achieved 2 months after surgery. Endoscopic examination indicated marked improvement of the duodenal lesions. In conclusion, GRPH is a less invasive surgical procedure for GP compared with other surgical procedures and may be an alternative for the surgical treatment of GP without severe lesions or stenosis of the duodenum.

• groove pancreatitis
• groove resection
• pancreas

• CT scan of the abdomen
• Pancreatitis
• Pancreatoduodenal groove
• Whipple’s pancreaticoduodenectomy

• Cystic dystrophy of the duodenum
• Groove pancreatitis
• Heterotopic pancreas
• Myoepithelial hamartoma
• Paraduodenal pancreatitis

• Choristoma/complications
• Choristoma/diagnostic imaging
• Diagnosis, Differential
• Humans
• Pancreas
• Terminology as Topic

• pancreatic cancer
• pancreatitis
• treatment outcome

Paraduodenal pancreatitis (PP) is a unique form of focal chronic pancreatitis that selectively involves the duodenum and aberrant pancreatic tissue located near the minor papilla (beyond the pancreas proper). The pseudotumoral nature of the disease often generates considerable clinical quandary and patient apprehension, and therefore merits a better understanding. The present study appraises the clinicoradiological manifestations of PP in 33 patients.

Clinical, laboratory, and radiological manifestations of 33 patients of PP treated in gastroenterology/hepatology and hepato-pancreatico-biliary surgery units during June 2010-August 2014 were retrospectively reviewed.

All patients were young to middle-aged men (100%) with history of alcohol abuse (93.9%) and/or smoking (42.4%), who presented either with acute or gradually worsening abdominal pain (90.9%). Pancreatic enzymes and serum tumor markers remained normal or were mildly/transiently elevated. Cystic variant was detected in 57.6% (solid in 42.4%); the disease remained confined to the groove/duodenum (pure form) in 45.4%. Medial duodenal wall thickening with increased enhancement was seen in 87.87 and 81.81%, respectively, and duodenal/paraduodenal cysts were seen in 78.78%. Pancreatic calcifications and biliary stricture were seen 27.3% patients. Peripancreatic arteries were neither infiltrated nor encased.

PP has a discrete predilection for middle-aged men with history of longstanding alcohol abuse and/or smoking. Distinguishing imaging findings include thickening of the pancreatic side of duodenum exhibiting increased enhancement with intramural/paraduodenal cysts. This may be accompanied by plate-like scar tissue in the groove region, which may simulate groove pancreatic carcinoma. However, as opposed to carcinoma, the peripancreatic arteries are neither infiltrated nor encased, rather are medially displaced.

• Chronic pancreatitis
• computed tomography
• magnetic resonance imaging
• pancreatitis