Duodenum-preserving pancreatic head resections for surgical treatment of paraduodenal pancreatitis
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paraduodenal pancreatitis, duodenum-preserving pancreatic head resections, surgical treatment, pain syndrome, Izbicki pain score

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Usenko, O. Y., Kopchak, V. M., Khomiak, I. V., Khomiak, A. I., & Malik, A. V. (2020). Duodenum-preserving pancreatic head resections for surgical treatment of paraduodenal pancreatitis. Herald of Pancreatic Club, 49(4), 51-54. https://doi.org/10.33149/vkp.2020.04.04

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Introduction. Up to date, no consensus exists on the surgical treatment of paraduodenal pancreatitis (PDP). Most authors prefer to perform pancreaticoduodenectomy when surgical treatment is indicated. However, such an aggressive approach may not always be justified for the treatment of benign disease. The aim of our study was to investigate the results of duodenum-preserving pancreatic head resections (DPPHR) for the treatment of PDP.

Materials and methods. We performed a retrospective analysis of a database consisting of 112 patients with PDP treated in Shalimov National Institute of Surgery and Transplantology from 2014 to 2019. A total of 45 patients after DPPHR were included to the study. Such modifications of DPPHR as Frey’s, Beger’s and Berne’s procedures were used. The primary study endpoint was pain control assessed according to the Izbicki pain score before surgery and at follow-up visits. Secondary endpoints were defined as complication rate (Clavien — Dindo >2), hospital length of stay and 90-day mortality. All patients were followed-up for the assessment of pain cessation with a median of 33 months (range 8–54 months).

Results. There were 42 males (93.3%) and 3 females (6.7%) in the study group. Preoperative Izbicki pain score result was 52.6 points. Follow-up pain score results were significantly lower at 11.7 points. Postoperative complication rate (Clavien — Dindo >2) was measured at 8.9%. Median hospital length of stay was 17.4 days. No mortality was recorded in the study group. All results were statistically significant (p<0.05).

Conclusion. Application of DPPHR for the surgical treatment of PDP allows to achieve excellent results in terms of pain control (52.6 and 11.7 points on the Izbicki pain score before surgical intervention and at follow-up), while maintaining low complication (8.9%) and mortality (0%) rates.

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1. Adsay N.V., Zamboni G. Paraduodenal pancreatitis: A clinico-pathologically distinct entity unifying “cystic dystrophy of heterotopic pancreas,” “para-duodenal wall cyst,” and “groove pancreatitis.” Semin. Diagn. Pathol. 2004. Vol. 21, No 4. P. 247–254.
2. Bloechle C., Izbicki J.R., Knoefel W. T., Kuechler T., Broelsch C. E. Quality of life in chronic pancreatitis, results after duodenum-preserving resection of the head of the pancreas. Pancreas. 1995. Vol. 11, No 1. P. 77–85.
3. De Pretis N., Capuano F., Amodio A., Pellicciari M., Casetti L., Manfredi R. et al. Clinical and morphological features of paraduodenal pancreatitis: an italian experience with 120 patients. Pancreas. 2017. Vol. 46, No 4. P. 489–495.
4. Dindo D., Demartines N., Clavien P. A. Classification of surgical complications: A new proposal with evaluation in a cohort of 6336 patients and results of a survey. Annals of Surgery. 2004. Vol. 240. P. 205–213.
5. Itoh S., Yamakawa K., Shimamoto K., Endo T., Ishigaki T. CT findings in groove pancreatitis: Correlation with histopathological findings. J. Comput. Assist. Tomogr. 1994. Vol. 18, No 6. P. 911–915.
6. Keck T., Adam U., Makowiec F., Riediger H., Wellner U., Tittelbach-Helmrich D. et al. Short- and long-term results of duodenum preservation versus resection for the management of chronic pancreatitis: a prospective, randomized study. Surgery. 2012. Vol. 152, No 3, Suppl. 1. P. S95–102.
7. Kempeneers M.A., Issa Y., Ali U. A., Baron R. D., Besselink M. G., Büchler M. et al. International consensus guidelines for surgery and the timing of intervention in chronic pancreatitis. Pancreatology. 2020. Vol. 20, No 2. P. 149–157.
8. Muraki T., Kim G.E., Reid M. D., Mittal P., Bedolla G., Memis B. et al. Paraduodenal pancreatitis: imaging and pathologic correlation of 47 cases elucidates distinct subtypes and the factors involved in its etiopathogenesis. Am. J. Surg. Pathol. 2017. Vol. 41, No 10. P. 1347–1363.
9. Potet F., Duclert N. Cystic dystrophy on aberrant pancreas of the duodenal wall. Arch. Fr. Mal. App. Dig. 1970. Vol. 59, No 4. P. 223–238.
10. Raman S.P., Salaria S.N., Hruban R. H., Fishman E. K. Groove pancreatitis: spectrum of imaging findings and radiology-pathology correlation. Am. J. Roentgenol. 2013. Vol. 201, No 1. P. W29–39.
11. Usenko O.Y., Kopchak V.M., Khomiak I. V., Khomiak A. I., Malik A. V. Results of surgical treatment of paraduodenal (groove) pancreatitis. Klin. Khir. 2019. Vol. 85, No 11. P. 5–8.
12. Whitcomb D.C., Frulloni L., Garg P., Greer J. B., Schneider A., Yadav D. et al. Chronic pancreatitis: An international draft consensus proposal for a new mechanistic definition. Pancreatology. 2016. Vol. 16, No 2. P. 218–224.