Clinical impact of duodenal pancreatic heterotopia - Is there a need for surgical treatment?

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

  • Alexander Betzler - , Universitätsklinikum Carl Gustav Carus Dresden, Klinik und Poliklinik für Viszeral-, Thorax- und Gefäßchirurgie (Autor:in)
  • Soeren T. Mees - , Universitätsklinikum Carl Gustav Carus Dresden, Klinik und Poliklinik für Viszeral-, Thorax- und Gefäßchirurgie (Autor:in)
  • Josefine Pump - , Universitätsklinikum Carl Gustav Carus Dresden, Klinik und Poliklinik für Viszeral-, Thorax- und Gefäßchirurgie (Autor:in)
  • Sebastian Schölch - , Universitätsklinikum Carl Gustav Carus Dresden, Klinik und Poliklinik für Viszeral-, Thorax- und Gefäßchirurgie (Autor:in)
  • Carolin Zimmermann - , Universitätsklinikum Carl Gustav Carus Dresden, Klinik und Poliklinik für Viszeral-, Thorax- und Gefäßchirurgie (Autor:in)
  • Daniela E. Aust - , Institut für Pathologie, Universitätsklinikum Carl Gustav Carus Dresden (Autor:in)
  • Jürgen Weitz - , Klinik und Poliklinik für Viszeral-, Thorax- und Gefäßchirurgie, Universitätsklinikum Carl Gustav Carus Dresden (Autor:in)
  • Thilo Welsch - , Universitätsklinikum Carl Gustav Carus Dresden, Klinik und Poliklinik für Viszeral-, Thorax- und Gefäßchirurgie (Autor:in)
  • Marius Distler - , Klinik und Poliklinik für Viszeral-, Thorax- und Gefäßchirurgie, Universitätsklinikum Carl Gustav Carus Dresden (Autor:in)

Abstract

Background: Pancreatic heterotopia (PH) is defined as ectopic pancreatic tissue outside the normal pancreas and its vasculature and duct system. Most frequently, PH is detected incidentally by histopathological examination. The aim of the present study was to analyze a large single-center series of duodenal PH with respect to the clinical presentation. Methods: A prospective pancreatic database was retrospectively analyzed for cases of PH of the duodenum. All pancreatic and duodenal resections performed between January 2000 and October 2015 were included and screened for histopathologically proven duodenal PH. PH was classified according to Heinrich’s classification (Type I acini, ducts, and islet cells; Type II acini and ducts; Type III only ducts). Results: A total of 1274 pancreatic and duodenal resections were performed within the study period, and 67 cases of PH (5.3%) were identified. The respective patients were predominantly male (72%) and either underwent pancreatoduodenectomy (n = 60); a limited pancreas resection with partial duodenal resection (n = 4); distal pancreatectomy with partial duodenal resection (n = 1); total pancreatectomy (n = 1); or enucleation (n = 1). Whereas 65 patients (83.5%) were asymptomatic, 11 patients (18.4%) presented with symptoms related to PH (most frequently with abdominal pain [72%] and duodenal obstruction [55%]). Of those, seven patients (63.6%) had chronic pancreatitis in the heterotopic pancreas. The risk of malignant transformation into adenocarcinoma was 2.9%. Conclusions: PH is found in approximately 5% of pancreatic or duodenal resections and is generally asymptomatic. Chronic pancreatitis is not uncommon in heterotopic pancreatic tissue, and even there is a risk of malignant transformation. PH should be considered for the differential diagnosis of duodenal lesions and surgery should be considered, especially in symptomatic cases.

Details

OriginalspracheEnglisch
Aufsatznummer53
FachzeitschriftBMC surgery
Jahrgang17
Ausgabenummer1
PublikationsstatusVeröffentlicht - 8 Mai 2017
Peer-Review-StatusJa

Externe IDs

PubMed 28482873

Schlagworte

Ziele für nachhaltige Entwicklung

ASJC Scopus Sachgebiete

Schlagwörter

  • Chronic pancreatitis, Heinrich’s classification, Pancreatic cancer, Pancreatic heterotopia, Pancreatic resection