[Surgical therapy of chronic pancreatitis: the devil's advocate commentary]

Chronic pancreatitis is despite increasing incidence a rare disease. Studies about its natural history are sparse. Undisputed indication for operative intervention are local complications. Intractable pain without such local complications should only seldom be an indication for pancreatic surgery. Since very different surgical procedures are performed in similar anatomical situations randomized prospective studies are needed. The problems of controlled studies in surgery are discussed.