title: Groove pancreatitis. A mini-series report and review of the literature.
abstract: BACKGROUND
  Groove pancreatitis is a rare condition characterized by fibrotic inflammation affecting the groove anatomical area between the head of the pancreas, the duodenum and the common bile duct.
  
  
  OBJECTIVE
  We report a miniseries of five cases treated surgically in our centre over a period of four years. A review of the literature is also discussed.
  
  
  METHODS
  Patients undergoing pancreaticoduodenectomy over a four-year period were retrospectively reviewed. Patients with a confirmed histological diagnosis of groove pancreatitis were assessed under the headings; patient demographics, presenting symptoms, radiological and histological findings.
  
  
  RESULTS
  One-hundred and 60 pancreaticoduodenectomies were performed. Thirty-nine cases demonstrated benign disease and within this, five cases (3.1% of total series; 12.8% of benign cases) were groove pancreatitis. All patients presented with abdominal pain and weight loss, and the majority consumed excess alcohol and were smokers. Radiological findings (CT/MRCP/EUS) revealed duodenal wall thickening in all cases, abnormalities at the head of pancreas and bile duct dilation in four, and cystic changes in the duodenal wall and pancreatic duct dilation in three cases. Groove fibrosis, Brunner's gland hyperplasia and cystic changes in duodenal wall were present in all cases on histological review. All patients reported significant improvement in quality of life at 12 months after surgery.
  
  
  CONCLUSIONS
  Groove pancreatitis can present in a similar fashion to head of pancreas cancer and chronic pancreatitis. For this reason it is paramount for clinicians to be aware of groove pancreatitis, as this can lead to the correct diagnosis and management of this unique disease.
authors.affiliation: Department of Hepatobiliary Surgery, Surgery and Diagnostics Centre, Churchill Hospital, Headington, Oxford, UK.
authors.forename: Antonio
authors.initials: A
authors.lastname: Manzelli
authors.forename: Athanasios
authors.initials: A
authors.lastname: Petrou
authors.forename: Alesandra
authors.initials: A
authors.lastname: Lazzaro
authors.forename: Nicholas
authors.initials: N
authors.lastname: Brennan
authors.forename: Zahir
authors.initials: Z
authors.lastname: Soonawalla
authors.forename: Peter
authors.initials: P
authors.lastname: Friend
mesh_terms: D000328:Adult; D000368:Aged; D003135:Common Bile Duct / Q000473:pathology* / Q000601:surgery; D004386:Duodenum / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000473:pathology* / Q000601:surgery; D010195:Pancreatitis / Q000175:diagnosis* / Q000601:surgery; D012189:Retrospective Studies