title: Outcomes After Conservative, Endoscopic, and Surgical Treatment of Groove Pancreatitis: A Systematic Review.
abstract: BACKGROUND
  Groove pancreatitis (GP) is a focal form of chronic pancreatitis affecting the paraduodenal groove area, for which consensus on diagnosis and management is lacking.
  
  
  OBJECTIVE
  We performed a systematic review of the literature to determine patient characteristics and imaging features of GP and to evaluate clinical outcomes after treatment.
  
  
  RESULTS
  Eight studies were included reporting on 335 GP patients with a median age of 47 years (range, 34 to 64 y), with 90% male, 87% smokers, and 87% alcohol consumption, and 47 months (range, 15 to 122 mo) of follow-up. Most patients presented with abdominal pain (91%) and/or weight loss (78%). Imaging frequently showed cystic lesions (91%) and duodenal stenosis (60%).Final treatment was conservative (eg, pain medication) in 29% of patients. Endoscopic treatment (eg, pseudocyst drainage) was applied in 19% of patients-34% of these patients were subsequently referred for surgery. Overall, 59% of patients were treated surgically (eg, pancreatoduodenectomy). Complete symptom relief was observed in 50% of patients who were treated conservatively, 57% who underwent endoscopic treatment, and 79% who underwent surgery.
  
  
  CONCLUSIONS
  GP is associated with male gender, smoking, and alcohol consumption. The vast majority of patients presents with abdominal pain and with cystic lesions on imaging. Although surgical treatment seems to be the most effective, both conservative and endoscopic treatment are successful in about half of patients. A stepwise treatment algorithm starting with the least invasive treatment options seems advisable.
authors.affiliation: *Department of Gastroenterology & Hepatology, Noordwest Ziekenhuisgroep, Alkmaar Departments of †Gastroenterology & Hepatology §Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands ‡Department of Gastroenterology & Hepatology, Hepatopancreatology and GI Oncology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: Liesbeth M
authors.initials: LM
authors.lastname: Kager
authors.forename: Selma J
authors.initials: SJ
authors.lastname: Lekkerkerker
authors.forename: Marianna
authors.initials: M
authors.lastname: Arvanitakis
authors.forename: Myriam
authors.initials: M
authors.lastname: Delhaye
authors.forename: Paul
authors.initials: P
authors.lastname: Fockens
authors.forename: Marja A
authors.initials: MA
authors.lastname: Boermeester
authors.forename: Jeanin E
authors.initials: JE
authors.lastname: van Hooft
authors.forename: Marc G
authors.initials: MG
authors.lastname: Besselink
mesh_terms: D004322:Drainage; D004724:Endoscopy; D006801:Humans; D050500:Pancreatitis, Chronic / Q000628:therapy*; D015607:Stents; D016896:Treatment Outcome