A Comparative Study on Quality of Life Between Primary Early Surgery and Late Surgery in Chronic Calcific...

We aim to test the hypothesis that "primary early surgery (i.e., within 2 years from symptoms onset) in chronic calcific pancreatitis (CCP) has better durable long-term Quality of Life (QOL) than patients undergoing late surgery (> 2 years from symptom onset)" using the SF-36 questionnaire.

This is a prospective observational study conducted between 2016 and 2025. 162 patients with large-duct CCP (MPD diameter ≥ 6 mm) underwent either Frey's procedure or lateral pancreatico-jejunostomy (LPJ). 62/162 patients on regular follow -up were included in the study. The 62 patients were grouped into primary early surgery group (PESG) and late surgery group (LSG). After long term (> 3 year) of follow-up, patient's responses regarding QOL were recorded using the SF-36 questionnaire and compared. The primary outcome measures were pain, physical functioning and role limitations due to physical health and the other components on the SF-36 were taken as secondary outcome measures.

27/62 cases were in LSG and 35/62 belonged to PESG. Mann-Whitney U test was used to make group comparisons. 7 out of 8 components namely Pain, Physical Functioning, Role Limitations Due to Physical Health, Role Limitations Due to Emotional Problems, Energy/ Fatigue, Emotional Well-Being, Social Functioning had statistically significant difference favoring better QOL in PESG.

Primary early surgery has a positive impact on long-term QOL in patients with CCP. However, future RCTs will help to draw solid conclusions to support or refute our observations.