Duodenopancreatectomy for cystic dystrophy in heterotopic pancreas of the duodenal wall.
OBJECTIVE
Cystic dystrophy in heterotopic pancreas (CDHP) is rare. The aim of this study was to evaluate the diagnosis, management, and follow-up of the CDHP.


METHODS
Between August 1990 and March 2004, 12 patients with CDHP underwent a duodenopancreatectomy. The patients were retrospectively reviewed.


RESULTS
There were 11 men and 1 woman with a mean age of 42.4 years (range: 34-54 years). Nine patients (75%) were alcoholic and 8 patients had chronic pancreatitis. The diagnosis of CDHP was performed in 8 patients (66.6%) after the preoperative workup. Seven patient had a medical treatment with octreotid and endoscopic cystic ponction (N=3) or cystic fenestration (N=1). Recurrence of pain was noted after a mean period of 5 months. Three patients had recurrent acute pancreatitis. Duodenopancreatectomy was performed in all cases. The mortality and morbidity rate were respectively 8.3% (N=1) and 25% (N=3). Mean follow-up was 64 months (ranges: 6 - 158 months). One patient was seen 70 months later with epigastric pain and features of acute pancreatitis of the pancreatic stump due to anastomotic stenosis. The other patients were asymptomatic.


CONCLUSIONS
Diagnosis of CDHP is difficult. After failure of medical treatment, duodenopancreatectomy can be proposed.
Pessaux
Patrick
P
Service de Chirurgie Digestive, CHU Angers. pessauxpchuangers@yahoo.fr
Lada
Paul
P
Etienne
Sandrine
S
Tuech
Jean-Jacques
JJ
Lermite
Emilie
E
Brehant
Olivier
O
Triau
Stéphane
S
Arnaud
Jean-Pierre
JP
D000328:Adult; D000437:Alcoholism; D002828:Choristoma / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D004378:Duodenal Diseases / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain; D010179:Pancreas; D016577:Pancreaticoduodenectomy; D010195:Pancreatitis / Q000209:etiology; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome