title: Pancreatico-duodenectomy for complicated groove pancreatitis.
abstract: OBJECTIVE
  Groove pancreatitis (GP) describes a form of segmental pancreatitis, which affects the pancreatic head at the interface with the duodenum, and is frequently associated with ectopic pancreatic tissue in the duodenal wall. We present a series of symptomatic patients with complicated GP who underwent pancreaticoduodenectomy, and review the diagnostic challenges, imaging modalities, pathological features and clinical outcome of this rare condition.
  
  
  METHODS
  This was a prospective case base study of clinical, radiological and pathological data collected between the years 2000 and 2005 on patients diagnosed with severe GP--confirmed by histopathological examination following pancreaticoduodenectomy.
  
  
  RESULTS
  In total 11 patients were included, presenting with chronic abdominal pain (n=11), gastric outlet obstruction (n=5) and jaundice (n=1). Exocrine dysfunction with associated weight loss (median > 9 kg) was present in 10 patients, and type 2 diabetes in 2 patients. Radiological imaging (CT/MRCP/EUS) provided complementary investigations and correlated well with classic histopathological findings (duodenal wall thickening, mucosal irregularity and Brunner's gland hyperplasia, duodenal wall cysts and pancreatic heterotropia). Following pancreaticoduodenectomy (median follow-up period 52 weeks) all patients experienced significant pain alleviation and weight gain (average 3 kg at 2 months).
  
  
  CONCLUSIONS
  Pancreaticoduodenectomy is associated with significant improvements in weight gain and alleviates the chronic pain associated with severe GP.
authors.affiliation: Department of Surgery, Leeds Teaching Hospitals NHS Trust, Leeds, UK. zak-rahman@lineone.net
authors.forename: Sakhawat H
authors.initials: SH
authors.lastname: Rahman
authors.forename: Caroline S
authors.initials: CS
authors.lastname: Verbeke
authors.forename: Dhanwant
authors.initials: D
authors.lastname: Gomez
authors.forename: Michael J
authors.initials: MJ
authors.lastname: McMahon
authors.forename: Krishna V
authors.initials: KV
authors.lastname: Menon