Long-term results after surgical management of chronic pancreatitis

BACKGROUND/AIMS: Long-term outcome in surgery for chronic pancreatitis remains relatively unknown. METHODOLOGY: 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). RESULTS: 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%). CONCLUSIONS: 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.