Jornal de Hepatologia e Distúrbios Gastrointestinais
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Early Surgery for Chronic Pancreatitis

Iurii Mikheiev

Introduction: Chronic pancreatitis (CP) is a disease of the pancreas in which recurrent inflammatory episodes result in replacement of the pancreatic parenchyma by fibrous connective tissue. Patients with End Stage CP typically struggle with pain relief, stigmatization, unemployment, and depression and often have among the worst quality of life measures for any chronic disease.

Objectives: To examine if surgery performed for pain and complications of CP within 2 years diagnosis has greater odds of achieving complete pain relief than later surgery.

Methods: Retrospective review of records at a tertiary institution 2000 to 2020 for CP where the operative indication was pain and complications of CP. Patients were divided into 2 groups, group 1 - 120 patients, less than 2 years from the moment of CP diagnosis and group 2 - 94 patients with disease duration of more than 2 years.

Results: From the statistics of significant differences between the groups, the following should be noted: the size of the pancreatic head in group 1 was less than in group 2 - 36,791,22 mm VS 40,481,25 mm (р<0,05); pancreatic parenchyma calcifications -  35 (29,2%)VS 46 (48,9%), 2=8,76; р<0,01; calculi of the main pancreatic duct - 16 (13,3%)VS 26 (27,7%), 2=6,86; р<0,01; time of surgery - 101,616,31 min VS 128,856,05 min (р<0,05); the number of minimally invasive procedures under ultrasound guidance – 25 (20,8%) VS 8 (8,5%)2=3,97; р<0,05; the number of duodenum-preserving pancreatic resections 33 (27,5%) VS 38 (40,4%); quality of life after surgery on a five-point scale - 3,750,05 VS 3,260,07(р<0,01). 

Conclusions: The results of the analysis of one institution show that early surgical intervention within 2 years or less diagnosis is associated with an improvement in the quality of life and minimization of the volume of surgical procedures.