O146 Natural history and clinical outcomes in patients with groove pancreatitis: an observational study

Abstract

Abstract Introduction Groove pancreatitis (GP) is a rare and focal form of pancreatitis affecting the para-duodenal groove area. Diagnosis is usually made by radiological imaging or histological analysis. This study aimed to determine the disease pattern, treatment modalities and outcomes. Methods Data were retrospectively collected for patients diagnosed with GP radiologically and/or histologically at our tertiary hospital from 2010 to 2019. A search of our imaging database was conducted using the term groove pancreatitis totalling 1,040 patients. Duplicates (95) and reports mentioning only groove or only pancreatitis (945) were eliminated. All included patients were then re-assessed by two expert hepatopancreaticobiliary radiologists and a specialist histopathologist to confirm inclusion. Results Our cohort comprised of 54 patients, 39 males and 15 females. The mean age was 67 years (range 39-101 years). Of the 54 patients, 11 had pancreatic cancer (20%). Pain as a main presenting complaint occurred in 78% and jaundice in only 13%. 26% had elevated lipase and 37% had deranged LFTs. 69% were managed conservatively as first line. 11% of patients failed conservative management and proceeded to endoscopic treatment. Surgical intervention occurred in 24%. 11% of all patients had complete symptom relief, and 76% showed symptom improvement. Mortality at 2years of follow-up, was 45% and 28% in those with and without cancer. Conclusion GP is a benign disease with a non-specific natural history. It remains unclear if there is a transition between GP and GP-associated mass. This emphasises a high index of suspicion in diagnosis, using radiological, endoscopic, and cytological analysis.