[Chronic pancreatitis--conservative versus surgical treatment under prognostic aspects]

Because of the differently selected groups of patients due to a narrow indication for pancreatic surgery, a direct comparison of the results of conservative and surgical therapy is not possible. A follow-up survey of 348 patients with proven chronic pancreatitis showed that patients suffering from uncomplicated pancreatitis should be treated conservatively as long as possible, for 70% (77 out of 109) will improve. In 2/3 of our patients with chronic pancreatitis, surgical treatment became necessary. As to the recurrence of pancreatitis and the lethality, resecting techniques were more successful (72%: 107 out of 148) than the non-resecting ones (61%: out of 91). The cooperation of the patient is crucial for the prognostic outcome regardless of the kind of treatment; especially the elimination of alcohol intake is essential. The most important accompanying or/and succeeding disease is diabetes mellitus, which impairs the long term prognosis especially because of the hazard of postoperative irreversible hypoglycemia. Optimal treatment of patients with chronic pancreatitis can only be accomplished on an individual basis and on the basis of a close cooperation of internists and surgeons.