# Pancreaticoduodenectomy with Anatomical Vascular Variant in Groove Pancreatitis—A Case Report

## TL;DR

A 66-year-old woman with groove pancreatitis underwent pancreatoduodenectomy after conservative treatments failed.

## Contribution

This case report highlights the surgical management of groove pancreatitis with anatomical vascular variants.

## Key findings

- Contrast-enhanced CT showed chronic pancreatitis, dilated pancreatic duct, and biliary tract enlargement.
- Surgery was the only effective treatment due to failed endoscopic approaches.
- The patient had a history of heavy smoking and typical symptoms like weight loss and abdominal pain.

## Abstract

Groove pancreatitis represents a chronic focal form of pancreatitis affecting the zone between the pancreatic head and the duodenal “C” loop, known as the groove area. This is a rare condition that affects the pancreatic periampullary part, including the duodenum and the common bile duct, which is usually associated with long-term alcohol and tobacco misuse, and is more frequent in men than in women. The most common clinical symptoms of groove pancreatitis include weight loss, acute abdominal pain, nausea, and jaundice. This report is about a 66-year-old woman with a history of heavy smoking, presenting with weight loss, nausea, and upper abdominal pain. Contrast-enhanced computed tomography revealed the existence of chronic pancreatitis as well as the dilatation of the main pancreatic duct, a cyst of the pancreatic head, and enlargement of the biliary tract. Conservatory treatment was initiated but with no improvement of symptoms. Since endoscopic retrograde cholangiopancreatography was not possible due to the local changes, we decided to perform pancreatoduodenectomy, as surgery appears to be the single effective treatment.