Surgical Management of Chronic Pancreatitis Shows Sustained Symptom Resolution on long term basis: Study

The study, published in The American Journal of Surgery, has revealed that the Whipple and Frey procedures are effective surgical choices for managing chronic pancreatitis that affects the proximal pancreas. These procedures typically result in long-lasting relief from symptoms for the majority of patients.

"Over 14 years, 74% reported being symptom-free shortly after surgery, with 84% maintained relief at a 2-year follow-up," the researchers reported. "Key predictors of successful outcomes included groove pancreatitis, shorter hospital stays, and absence of delayed gastric emptying post-surgery."

Persistent symptoms of chronic pancreatitis that do not respond to noninvasive treatments may necessitate surgical intervention. Both the Frey and Whipple procedures are suitable choices for managing proximal pancreas disease; however, there is limited data available regarding their impact on symptomatic outcomes.

To fill this knowledge gap, Savannah R. Smith, Department of Surgery, Emory University, Atlanta, GA, and colleagues conducted a retrospective analysis of patients who underwent surgical intervention for chronic pancreatitis of the proximal pancreas from 2005 to 2019. They evaluated preoperative patient characteristics and postoperative outcomes.

The following were the key findings of the study:

· One hundred forty patients underwent surgical intervention for chronic pancreatitis, 91 Whipple and 49 Frey procedures. The mean age was 53 years, and the mean BMI was 24.

· At post-operative follow-up, 74% were asymptomatic, and 84% at an average follow-up of 2 years.

· Groove pancreatitis, lack of post-operative delayed gastric emptying, and decreased length of stay predicted symptom resolution.

The findings showed that surgical management of chronic pancreatitis of the head or proximal pancreas is a viable option for persistently symptomatic patients. Most patients achieve resolution of symptoms within the initial 30 days following surgery, and they typically experience sustained improvement in symptoms over the long term.

Groove pancreatitis, decreased length of stay, and lack of postoperative delayed gastric emptying predicted symptom resolution.

In conclusion, the study provides valuable insights into the role of surgical management in achieving long-term symptom resolution for patients with chronic pancreatitis. As research progresses, advancements in surgical techniques hold promise for improving outcomes and enhancing the lives of individuals affected by this challenging condition.

Reference:

Smith, S. R., Jajja, M. R., & Sarmiento, J. M. (2024). Long-Term Symptom Resolution Following the Surgical Management of Chronic Pancreatitis. The American Journal of Surgery, 115810. https://doi.org/10.1016/j.amjsurg.2024.115810