Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Randomized trials have demonstrated the superiority of surgery over endoscopy in patients with symptomatic chronic pancreatitis. However, large international studies quantifying the impact of surgery on chronic pancreatitis are lacking. The aim of this study was to evaluate current practice across Europe regarding indications, surgical techniques, and outcomes of surgery for chronic pancreatitis. METHODS: A prospective multicentre study of consecutive patients undergoing surgery for symptomatic chronic pancreatitis from 22 centres in 13 countries from 1 June 2021 to 30 November 2022 was conducted. The outcome of interest in patients with pain as an indication was the Izbicki pain score at 6-month follow-up, with complete pain relief defined as an Izbicki pain score ≤10 and partial pain relief defined as an Izbicki pain score >10, but with a >50% decrease compared with the baseline score. Quality of life was assessed using Pancreatitis Quality of Life Instrument (PANQOLI) and 12-Item Short-Form (SF-12) surveys. Predictors of pain relief were analysed using multivariable analysis. RESULTS: Overall, 207 patients underwent surgery (24.6% underwent surgical drainage procedures, 29.5% underwent duodenum-preserving head resections, and 45.9% underwent formal pancreatic resections). Before surgery, 48.8% used opioids and 51.2% had undergone prior endoscopic treatment. Major morbidity occurred in 14.0% and the 90-day mortality rate was 1.4%. Among 113 patients operated on for pain, the median Izbicki pain score decreased from 61.3 to 19.0 at 6 months (P < 0.001). Pain relief was achieved in 72.6% (43 patients reported complete pain relief and 39 patients reported partial pain relief). PANQOLI and SF-12 Physical Component Summary scores improved significantly (P < 0.001). Longer symptom duration (OR 0.95 (95% c.i. 0.90 to 1.00), P = 0.045) and use of opioids before surgery (OR 3.16 (95% c.i. 1.04 to 9.64), P = 0.043) predicted less pain relief. CONCLUSION: Surgery for chronic pancreatitis across Europe was performed with low morbidity. Patients reported good pain relief and improvements in quality-of-life scores. Multidisciplinary consultation is recommended for all patients with chronic pancreatitis before undergoing any intervention.
Source: British journal of surgery
DOI: 10.1093/bjs/znaf068
Authors: Charlotte L van Veldhuisen, Charlotte A Leseman, Fleur E M De Rijk, Joana Marques-Antunes, Fabio Ausania, Orlin Belyaev, Frederik Berrevoet, Marja A Boermeester, Ugo Boggi, Stefan A Bouwense, Marco J Bruno, Olivier R Busch, Kevin C Conlon, Safi Dokmak, Massimo Falconi, Poya Ghorbani, Filip Gryspeerdt, Roel Haen, Arturan Ibrahimli, Jakob R Izbicki, Christina Krikke, Arto Kokkola, Lancelot Marique, J Sven D Mieog, Gennaro Nappo, Janis Pavulans, Haralds Plaudis, Geert Roeyen, Pasquale Scognamiglio, Domenico Tamburrino, Tore Tholfsen, Marie Toschka, Faik G Uzunoglu, Susan van Dieren, Casper H J Van Eijck, Jeanin E van Hooft, Hjalmar C van Santvoort, Robert C Verdonk, Rogier P Voermans, Anne Waage, Marc G Besselink
Institutions: Amsterdam UMC Location University of Amsterdam, St. Antonius Ziekenhuis, Amsterdam University Medical Centers, Amsterdam Gastroenterology Endocrinology Metabolism, University of Amsterdam, Erasmus MC, Erasmus University Rotterdam, Hospital Clínic de Barcelona, Consorci Institut D'Investigacions Biomediques August Pi I Sunyer, Universitat de Barcelona, St. Josef-Hospital, Ruhr University Bochum, Ghent University Hospital, University of Pisa, Maastricht University Medical Centre, Trinity College Dublin, Tallaght University Hospital, Inserm, Université Paris Cité, Hôpital Beaujon, Assistance Publique – Hôpitaux de Paris, Centre de Recherche sur l'Inflammation, Vita-Salute San Raffaele University, Karolinska University Hospital, Erasmus MC Cancer Institute, University Medical Center Hamburg-Eppendorf, University Medical Center Groningen, University of Groningen, University of Helsinki, Helsinki University Hospital, Leiden University, Leiden University Medical Center, Humanitas University, Riga East University Hospital, University of Antwerp, Antwerp University Hospital, Oslo University Hospital, University Medical Center Utrecht
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $5,007
OpenAlex ID: W4409903105