Long-term follow-up results of surgery for chronic pancreatitis

Based on a mean follow-up period of 86 months, the long-term results of 87 drainage and resection operations performed for chronic pancreatitis between 1990-94 were evaluated.

To evaluate the results, two questionnaires were filled out by the patients. The first was related to the pancreatitis and the long-term complications, the second was a Gastrointestinal Quality of Life Index questionnaire. Data of deceased patients were collected with the help of general practitioners.

Based on the analysis of disease-related and quality of life questionnaire forms only 34% of the investigated patients could be classified as a group showing good results. There was a high incidence of long-term mortality (25%). Eighty-three percent of the deceased patients (18 patients) died after the seventh postoperative year. The most threatened group seems to be the alcoholic and insulin-dependent diabetic one. The combination of the two pathologies was the cause of death in a third of the cases. Insulin-dependent diabetes mellitus developed in 13 patients after an average of 3.9 years following surgery, mainly as a consequence of the irreversible and progressive nature of disease. The rate of disability was 51%. No significant difference could be demonstrated between the resected and the decompressed group according to either disability or late mortality rate.

Based on these results, the authors wish to emphasize that in chronic pancreatitis the short-term follow-up results may be deceptive, and that the real outcome of the surgical treatment can only be expected five years following surgery.