Gut Liver.  2018 Mar;12(2):208-213. 10.5009/gnl17170.

Groove Pancreatitis: Endoscopic Treatment via the Minor Papilla and Duct of Santorini Morphology

Affiliations
  • 1Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. isayama-tky@umin.ac.jp
  • 2Department of Internal Medicine, Police General Hospital, Bangkok, Thailand.
  • 3Department of Gastroenterology, Toshiba General Hospital, Tokyo, Japan.
  • 4Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.

Abstract

BACKGROUND/AIMS
Groove pancreatitis (GP) is an uncommon disease involving the pancreaticoduodenal area. Possible pathogenesis includes obstructive pancreatitis in the duct of Santorini and impaired communication with the duct of Wirsung, minor papilla stenosis, and leakage causing inflammation. Limited data regarding endoscopic treatment have been published.
METHODS
Seven patients with GP receiving endoscopic treatment were reviewed. The morphology of the pancreatic duct was evaluated by a pancreatogram. Endoscopic dilation of the minor papilla and drainage of the duct of Santorini were performed.
RESULTS
There were two pancreatic divisum cases, one ansa pancreatica case and four impaired connections between the duct of Santorini and the main pancreatic duct. Three to 31 sessions of endoscopy, with 2 to 24 sessions of transpapillary stenting and dilation, were performed. Interventions through the minor papilla were successfully performed in six of seven cases. The pancreatic stenting duration ranged from 2 to 87 months. Five patients with evidence of chronic pancreatitis (CP) tended to receive more endoscopic interventions than did the two patients without CP (2-24 vs 2, respectively) for GP and other complications associated with CP.
CONCLUSIONS
Disconnection or impairment of communication between the ducts of Santorini and Wirsung was observed in all cases of GP. No surgery was required, and endoscopic minor papilla dilation and drainage of the duct of Santorini were feasible for the treatment of GP.

Keyword

Groove pancreatitis; Endoscopic treatment; Pancreatic ducts; Paraduodenal pancreatitis

MeSH Terms

Constriction, Pathologic
Drainage
Endoscopy
Humans
Inflammation
Pancreatic Ducts*
Pancreatitis*
Pancreatitis, Chronic
Stents
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