Clinical features and evolution of paraduodenal (groove) pancreatitis: A multicenter study

Abstract

Introduction: The pathogenesis and natural history of paraduodenal (groove) pancreatitis (PP) remain unclear, and treatment includes medical therapy, interventional endoscopy, and surgery. This is a multicenter study to explore the burden of the disease, its clinical course, and response to treatment.

Methods: Data were retrospectively collected from both academic and nonacademic Italian centers. All patients diagnosed with PP were included in the study. Data were recorded at the time of diagnosis and follow-up.

Results: 208 patients (87.5 % male) from 16 centers were recruited. The median age at diagnosis was 50.5 (IQR 13 years), and the mean time from clinical presentation to diagnosis was 18 (±29) months. 90.6 % (n = 107) had a history of alcohol abuse and 90.7 % (n = 185) had smoked. Thirty-six patients (17.9 %) had diabetes at diagnosis, while 80 patients (41.5 %) had chronic pancreatitis. Six (3 %) patients were diagnosed with pancreatic cancer after a mean time of 10.3 (±10.8) months from the PP diagnosis. Forty-nine patients (24.9 %) had pancreatic exocrine insufficiency (PEI) at diagnosis, while 45(24.3 %) developed PEI during follow-up. Conservative treatment was administered in 103 (54.5 %) cases, surgery in 52 (27.5 %), and endoscopic therapy in 34 (18 %). The mean follow-up was 41.1 (±31.92) months.

Conclusions: Alcohol consumption and smoking are major risk factors for PP. Diabetes and PEI commonly develop in these patients. Conservative treatment strategies are often successful.

Keywords: Chronic pancreatitis; Diffuse form; Groove pancreatitis; Pancreas; Pancreatic diseases; Pancreatology; Paraduodenal pancreatitis; Pure form.