Long-term results after surgical management of chronic pancreatitis

Long-term outcome in surgery for chronic pancreatitis remains relatively unknown.

Between 1963 and 1993, we performed 123 pancreatic resections and 35 drainage procedures for severe chronic pancreatitis. We reviewed 131 patients with a mean follow-up of 48 months (4 months to 18 years).

Actual 10-year survival was 82% for nonalcoholic patients and 51% for alcoholic pancreatitis. Pain was successfully treated in 71% with pancreatic resection and in 42% with drainage procedures (p<0.01). Although post-operative diabetes mellitus occurred in 56% of patients after pancreatic resection, long-term nutritional status was similar after pancreatic resection and drainage procedures. Weight gain could be observed in 75 patients (47%) and quality-of-life was good to excellent in 97 patients (74%).

In conclusion, long-term survival was mainly conditioned by the etiology of the disease. Pancreatic resections were more successful in treating intractable pain than drainage and required fewer re-interventions. As presumed, resections were associated with a higher rate of diabetes mellitus, but this, however, had no impact on long-term nutritional status and quality-of-life.