Diagnosis and treatment of duodenal dystrophy in patients with chronic pancreatitis

Kriger A.G.

Institut khirurgii im. A.V. Vishnevskogo, Moskva

Smirnov A.V.

Volgograd State Medical University, Volgograd, Russia

ORCID: 0000-0001-5351-6105

Berelavichus S.V.

Institut khirurgii im. A.V. Vishnevskogo, Moskva

Gorin D.S.

Institut khirurgii im. A.V. Vishnevskogo, Moskva

SPIN RSCI: 4284-4275
Scopus AuthorID: 35299202200
ORCID: 0000-0002-6452-4458

Karmazanovskiĭ G.G.

FGBU "Institut khirurgii im. A.V. Vishnevskogo" Minzdrava Rossii, Moskva

SPIN RSCI: 5964-2369
Scopus AuthorID: 55944296600

Vetsheva N.N.

FGBU "Institut khirurgii im. A.V. Vishnevskogo" Minzdrava Rossii, Moskva

Nerestyuk Ya.I.

A.V. Vishnevsky Institute of Surgery, Health Ministry of the Russian Federation, Moscow

Kalinin D.V.

Institut khirurgii im. A.V. Vishnevskogo Minzdrava RF, Moskva

Glotov A.V.

Kafedra urologii Moskovskogo gosudarstvennogo mediko-stomatologicheskogo universiteta

Diagnosis and treatment of duodenal dystrophy in patients with chronic pancreatitis

Authors:

Kriger A.G., Smirnov A.V., Berelavichus S.V., Gorin D.S., Karmazanovskiĭ G.G., Vetsheva N.N., Nerestyuk Ya.I., Kalinin D.V., Glotov A.V.

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Journal: Pirogov Russian Journal of Surgery. 2016;(8): 25‑32

DOI: 10.17116/hirurgia2016825-32

Read: 4570 times

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To cite this article:

Kriger AG, Smirnov AV, Berelavichus SV, et al. . Diagnosis and treatment of duodenal dystrophy in patients with chronic pancreatitis. Pirogov Russian Journal of Surgery. 2016;(8):25‑32. (In Russ.)
https://doi.org/10.17116/hirurgia2016825-32

Подписка 2025-2 (Pirogov Russian Journal of Surgery)

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Aim. To define optimal treatment of duodenal dystrophy in patients with chronic pancreatitis. Material and methods. 515 patients with chronic pancreatitis have been treated for the period 2004-2015 in A.V.Vishnevsky Institute of Surgery. Duodenal dystrophy (DD) was diagnosed in 79 (15.3%) of them. The diagnosis was confirmed by sonography, CT, MRI and endosonography. 5 patients are under observation without surgery. 74 patients were operated after previous medical therapy during 39 months on the average. Pancreatoduodenectomy was performed in 36 patients. Organ-sparing interventions were applied in 34 cases including different duodenal resections in 20 patients and pancreatic head resections in different modifications in 14 cases. 4 patients underwent palliative surgery. Chronic pancreatitis and DD were verified by morphological analysis of specimens. Long-term results were estimated in 47 patients. Median follow-up was 49.9 months. Results. X-ray diagnostics showed that DD was combined with chronic pancreatitis in 87.3% of cases while morphological analysis revealed 93.8%. Clinical signs of DD were caused by striated pancreatitis in 69.6% and ectopic pancreatic tissue in 30.4%. Clinical manifestations of DD did not depend on its cause and were presented by symptoms of chronic pancreatitis. Postoperative complications occurred in 25 (34.7%) patients. There were 33.5% of complications after pancreatoduodenectomy and 70% after duodenal resection. 1 patient died. Overall mortality was 1,3%. In long-term period complete regression of symptoms was observed in 66% of cases, significant improvement - in 32%, absence of the effect - in 2%. Conclusion. Medical therapy should be preferred for patients with DD and chronic pancreatitis. Surgery is indicated in case of persistent pain, complicated course of chronic pancreatitis and duodenal obstruction. Pancreatoduodenectomy and pancreatic head resection are preferred.

Keywords:

duodenal dystrophy

chronic pancreatitis

striated pancreatitis

diagnosis

surgical treatment

Authors:

Kriger A.G.

Institut khirurgii im. A.V. Vishnevskogo, Moskva

Smirnov A.V.

Volgograd State Medical University, Volgograd, Russia

ORCID: 0000-0001-5351-6105

Berelavichus S.V.

Institut khirurgii im. A.V. Vishnevskogo, Moskva

Gorin D.S.

Institut khirurgii im. A.V. Vishnevskogo, Moskva

SPIN RSCI: 4284-4275
Scopus AuthorID: 35299202200
ORCID: 0000-0002-6452-4458

Karmazanovskiĭ G.G.

FGBU "Institut khirurgii im. A.V. Vishnevskogo" Minzdrava Rossii, Moskva

SPIN RSCI: 5964-2369
Scopus AuthorID: 55944296600

Vetsheva N.N.

FGBU "Institut khirurgii im. A.V. Vishnevskogo" Minzdrava Rossii, Moskva

Nerestyuk Ya.I.

A.V. Vishnevsky Institute of Surgery, Health Ministry of the Russian Federation, Moscow

Kalinin D.V.

Institut khirurgii im. A.V. Vishnevskogo Minzdrava RF, Moskva

Glotov A.V.

Kafedra urologii Moskovskogo gosudarstvennogo mediko-stomatologicheskogo universiteta

List of references:

Dubova E.А., SHHegolev А.I. Вuodenal dystrophy. Аrkhiv patologii. 2009;4:47-50.(in Russian)
Egorov V.I., Kubyshkin V.А., Karmazanovskij G.G. i dr. Heterotopic pancreatic tissue as a cause of chronic pancreatitis. A typical and rare variants. Khirurgiya. 2006;11:58-62.(in Russian)
Stepanova YU.А., Karmazanovskij G.G.; Kubyshkin V.А. i dr. X-ray diagnosis of cystic forms of duodenal dystrophy. Аnnaly khirurgicheskoj gepatologii. 2009;14(2):95-103. (in Russian)
Adsay NV, Zamboni G. Paraduodenal pancreatitis: a clinico-pathologically distinct entity unifying ≪cystic dystrophy of heterotopic pancreas ≫, ≪para-duodenal wall cyst≫, and ≪groove pancreatitis≫. Semin Diagn Pathol. 2004;21:247-254.
Arora A, Rajesh S, Mukund A et al. Clinicoradiological appraisal of ≪paraduodenal pancreatitis≫: Pancreatitis outside the pancreas! Indian J Radiol Imaging. 2015;25(3):303-314.
Arvanitakis M, Rigaux J, Toussaint E et al. Endotherapy for paraduodenal pancreatitis: a large retrospective case series. Endoscopy. 2014;46(7):580-587.
Balakrishnan V, Unnikrishnan AG, Thomas V et. al. Chronic pancreatitis. A prospective nationwide study of 1,086 subjects from India. JOP. 2008;9(5):593-600.
Becker V, Mischke U. Groove pancreatitis. Int J Pancreatol. 1991;10:173-182.
Becker V. Bauchepeicheldruse. In: Doerr W, Seifert G, Uhlinger E, Eds. Spezielle Pathologische Anatomie, Chap 6. Berlin, Germany: Springer; 1973;252-445.
Beger HG, Matsuno S, Cameron JL. Diseases of the Pancreas: Current Surgical Therapy. Berlin: Springer-Verlag; 2008;949.
Beger HG, Schlosser W, Friess HM, Buchler MW. Duodenum-preserving head resection in chronic pancreatitis changes the natural course of the disease: a single-center 26-year experience. Ann Surg. 1999;230(4):512-519.
Casetti L, Bassi C, Salvia R et al. ≪Paraduodenal≫ pancreatitis: results of surgery on 58 consecutives patients from a single institution. World J Surg. 2009;33(12):2664-2669.
Dominguez-Munoz JE, Lucendo A, Carballo LF et al. A Spanish multicenter study to estimate the prevalence and incidence of chronic pancreatitis and its complications. Rev Esp Enferm Dig. 2014;106(4):239-245.
Egorov VI, Vankovich AN, Petrov RV et al. Pancreas-preserving approach to ≪paraduodenal pancreatitis≫ treatment: why, when, and how? Experience of treatment of 62 patients with duodenal dystrophy. Biomed Res Int. 2014;2014:185265.
Frulloni L, Gabbrielli A, Pezzilli R et. al. Chronic pancreatitis: report from a multicenter Italian survey (Pan Cro Inf AISP) on 893 patients. Dig Liver Dis. 2009;41(4):311-317.
Goldaracena N, McCormack L. A typical feature of groove pancreatitis. HPB (Oxford). 2012;14(7):487-488.
Levy P, Barthet M, Mollard BR et al. Estimation of the prevalence and incidence of chronic pancreatitis and its complications. Gastroenterol Clin Biol. 2006;30(6-7):838-844.
Nagai H. Configurational anatomy of the pancreas: its surgical relevance from ontogenetic and comparative-anatomical viewpoints. J Hepatobiliary Pancreat Surg. 2003;10(1):48-56.
Nagai H, Ohki J, Kondo Y et al. Duodenum-preserving pancreatic head resection (in Japanese). Geka (Surgery). 2003;57:816- 825.
Potet F, Duclert N. Cystic dystrophy on aberrant pancreas of the duodenal wall. Arch Fr Mal App Dig. 1970;59(4):223-238.
Rebours V, Levy P, Vullierme MP et al. Clinical and morphological features of duodenal cystic dystrophy in heterotopic pancreas. Am J Gastroenterol. 2007;102(4):871-879.
Ryu JK, Lee JK, Kim YT et al. Multicenter Study Group on Chronic Pancreatitis. Clinical features of chronic pancreatitis in Korea: a multicenter nationwide study. Digestion. 2005;72(4):207-211.
Stolte M, Weiss W, Volkholz H, Rosch W. A special form of segmental pancreatitis: ≪groove pancreatitis≫. Hepatogastroenterology. 1982;29:198-208.
Tezuka K, Makino T, Hirai I, Kimura W. Groove pancreatitis. Dig Surg. 2010;27(2):149-152.
Wagner M, Vullierme MP, Rebours V et al. Cystic form of paraduodenal pancreatitis (cystic dystrophy in heterotopic pancreas (CDHP)): a potential link with minor papilla abnormalities? A study in a large series. Eur Radiol. 2016;26(1):199-205.
Wang LW, Li ZS, Li SD et al. Prevalence and clinical features of chronic pancreatitis in China: a retrospective multicenter analysis over 10 years. Pancreas. 2009;38(3):248-254.

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