PANCREAS-PRESERVING DUODENECTOMY APPROACH TO TREATMENT OF ISOLATED FORM OF THE CYSTIC DYSTROPHY OF THE DUODENAL WALL (PURE FORM OF GROOVE PANCREATITIS)
Viacheslav Egorov*1, Roman V. Petrov1, Andrey Vankovich2, Eugeny Kondratiev3, Aleksandr Schegolev5, Elena Dubova4
1Surgiacal oncology, Bakhrushin Moscow City Hospital, Moscow, Russian Federation; 2Loginov Moscow Clinical Scientific Center, Moscow, Russian Federation; 3Vishnevsky Institute of Surgery, Moscow, Russian Federation; 4Buranazian Federal Medical and Biological Center of the Federal Medical and Biological Agency of Russian Federation, Moscow, Russian Federation; 5Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology, Moscow, Russian Federation
Background/Aims: Management of isolated form of cystic dystrophy of the duodenal wall (CDDW) or pure form of groove pancreatitis (GP), is a matter of controversy. We are reporting our experience of pancreas-preserving surgery for this disease.
Methods: A retrospective review of 82 patients with clinical, radiologic, and final pathologic confirmation of CDDW was presented (2004-2018). Fifteen of 82 patients were treated by pancreas-preserving duodenectomy(PPD).
Results: Preoperative diagnosis was correct in 79 cases (98,2%). Patients were presented with abdominal pain (100%), weight loss(76%), vomiting(30%) and jaundice(18%). CT,MRI, endoUS were the most useful diagnostic modalities. Twelve patients with CDDW were treated conservatively, 42 underwent pancreaticoduodenectomy(PD), pancreatico- and cystoenterostomies (8), duodenum-preserving pancreatic head (DPPH) resections(5) and PPD (15) without mortality. Full pain control was achieved after PPD in 93%, PD in 83%, and after DPPHR and draining procedures in 18% of cases. New diabetes mellitus (5) and exocrine insufficiency (5) developed after PD, and never registered after PPD. Weight gain was significantly greater after PD and PPD comparing to other treatment modalities.
Conclusions: PPD is the optimum method for treatment of the isolated form of CDDW; Early detection of CDDW allows pancreas preservation; Pure form of GP is a disease of the duodenum and Whipple procedure is an overtreatment for it.
Demographic data and symptoms before and after pancreas-preserving duodenectomies 
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