SURGICAL TREATMENT OF CHRONIC PANCREATITIS: A COMPARATIVE ANALYSIS OF RESULTS AND QUALITY OF LIFE
DOI:
https://doi.org/10.11603/2414-4533.2025.4.15744Keywords:
chronic pancreatitis, surgical treatment, quality of lifeAbstract
The aim of the work: to substantiate the nature and scope of surgical intervention in patients with chronic pancreatitis depending on the degree and nature of morpho-structural changes in the pancreatic tissue, and to perform a comparative assessment of the quality of life of the operated patients.
Materials and Methods. The research is based on the analysis of treatment results of 147 patients with various forms of chronic pancreatitis who were treated in a general surgical hospital. Of these, 47 (31.9 %) were operated on. Males accounted for 79.8 %, and females – 20.2 %, aged 30–75 years. The diagnostic program included laboratory and instrumental data, such as ultrasound (US); computed tomography (CT); fibrogastroduodenoscopy (FGDS); and endoscopic retrograde cholangiopancreatography (ERCP). Morphological features of fibrotic forms of chronic pancreatitis were studied. To detect exocrine insufficiency, the level of fecal elastase-1 in the stool was determined, and coprological examination was performed. To detect endocrine function, fasting glucose, HbA1c, and C-peptide were measured. The results of surgical treatment were evaluated as good, satisfactory, and unsatisfactory (according to the Vizik-Komorovski method 1992). The Izbicki pain scale was used to assess pain. Functional status was measured using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ C30). Preoperative management of patients was performed using the Fast Track Surgery technology. Statistical processing of the research results was carried out using biostatistical analysis methods, which were implemented in the licensed software packages Microsoft Office 2010 (Microsoft Excel 2010), and methods of variational statistics, and multivariate correlation analysis.
Results. The study results showed that surgical intervention for chronic pancreatitis is recognized as the most effective option for pain control. Our study compares the short-term dynamics of the pain syndrome and quality of life after drainage, combined, and resectional types of surgical interventions. The study systematized the indications for various types of operations depending on the clinical and morphological forms of chronic pancreatitis without a negative impact on the postoperative outcome.
Conclusions. A comparative evaluation of surgical interventions for clinical and morphological forms of chronic pancreatitis based on the intensity of the pain syndrome and the assessment of quality of life using the EORTC QLQ-C30 functional scale showed that resectional and combined operations had the best results. The selection of patients for surgical intervention is resolved multidisciplinarily with the involvement of a gastroenterologist, endocrinologist, and anesthesiologist.
References
Zafar HB. Surgical Management of Chronic Pancreatitis: A Systemic Review. Cureus. 2023 Mar 6; 15(3):e35806. DOI: 10.7759/cureus.35806. PMID: 36891174; PMCID: PMC9986717.
Dankha R, Sparrelid E, Gilg S, Löhr J-M, Ghorbani P. Surgical management of chronic pancreatitis: a narrative review. United European Gastroenterol J. 2025; 13(1):44-54. DOI: 10.1002/ueg2.12694.
Surci N, Bassi C, Salvia R, Marchegiani G, Casetti L, Deiro G, et al. Surgery for chronic pancreatitis: the comparison of two high-volume centers reveals lack of a uniform operative management. Langenbeck's Arch Surg. 2021; 406(8):2669-77. DOI: 10.1007/s00423-021-02335-1.
Kempeneers MA, Issa Y, Ali UA, Baron RD, Besselink MG, Büchler M, et al. International consensus guidelines for surgery and the timing of intervention in chronic pancreatitis. Pancreatology. 2020; 20(2):149-57. DOI: 10.1016/j.pan.2019. 12.005.
Udd M, Kylänpää L, Kokkola A. The role of endoscopic and surgical treatment in chronic pancreatitis. Scand J Surg. 2020; 109(1):69-78. DOI: 10.1177/1457496920910009.
Issa Y, Kempeneers MA, Bruno MJ, Fockens P, Poley JW, Ahmed AU, et al. Effect of early surgery vs endoscopy-first approach on pain in patients with chronic pancreatitis: the ESCAPE randomized clinical trial. JAMA. 2020; 323(3):237-47. DOI: 10.1001/jama.2019.20967.
Kňazovický M, Roškovičová V, Gajdzik T, Hildebrand T, Kaťuchová J, Radoňák J. The Role of Surgery in Chronic Pancreatitis. Pol Przegl Chir. 2024; 96(SUPLEMENT 1):97-102. DOI: 10.5604/01.3001.0053.9841.
Sarles H, Adler G, Dani R, Frey C, Gullo L, Harada H, Martin E, Norohna M, Scuro LA. The pancreatitis classification of Marseilles-Rome 1988. Scand J Gastroenterol. 1989 Aug; 24(6):641-2. DOI: 10.3109/00365528909093102. PMID: 2814334.
Beger HG, Büchler M, Bittner RR, Oettinger W, Roscher R. Duodenum-preserving resection of the head of the pancreas in severe chronic pancreatitis. Early and lateresult. Ann Surg.1989; 209(3):273-78. DOI: 10.1097/00000658-198903000-00004.
Beyer G, Habtezion A, Werner J, Lerch MM, Mayerle J. Chronic pancreatitis. Lancet. 2020; 396(10249):499-512. DOI: 10.1016/S0140-6736(20)31318-0.
Bouwense SAW, Kempeneers MA, van Santvoort HC, et al. Surgery in Chronic Pancreatitis: Indication, Timing and Procedures. Visc. Med. 2019; 35(2): 110-18. DOI: 10.1159/000 499612.
Frey CF, Smith GJ. Description and rationale of a new operation for chronic pancreatitis. Pancreas. 1987; 2(6):701-07.
Drewes AM, Bouwense SAW, Campbell CM et al. Guidelines for the understanding and management of pain in chronic pancreatitis. PANC. 2017; 17(5): 720-31. DOI: 10.1016/j.pan.2017.07.006.
Bloechle C, Izbicki JR, Knoefel WT, Kuechler T, Broelsch CE. Quality of life in chronic pancreatitis – results after duodenum- preserving resection of the head of the pancreas. Pancreas. 1995; 11:77-85.
Ashfaq A, Kolanu ND, Mohammed M, Oliveira Souza Lima SR, Rehman A, Shehryar A, Fathallah NA, Abdallah S, Abougendy IS, Raza A. Surgical Interventions in Chronic Pancreatitis: A Systematic Review of Their Impact on Quality of Life. Cureus. 2024 Feb. 10; 16(2):e53989. DOI: 10.7759/cureus.53989. PMID: 38476813; PMCID: PMC10928306.
Nychytaylo MYu, Zaporozhchenko BS, Horbunov AA, Muravyov PT, Bondaretsʹ DA. Khirurhichna taktyka likuvannya uskladnenykh form khronichnoho pankreatytu z ohlyadu na funktsionalʹnyy stan khvorykh [Surgical tactics of treatment of complicated forms of chronic pancreatitis considering the functional state of patients]. Klinichna khirurhiya. 2018; 85(1):17-19. Available from: http://nbuv.gov.ua/UJRN/KlKh_2018_1_6. Ukrainian.
Ke N, Jia D, Huang W, Nunes QM, Windsor JA, Liu X, et al. Earlier surgery improves outcomes from painful chronic pancreatitis. Medicine (Baltimore). 2018; 97:e0651.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 І. Я. ДЗЮБАНОВСЬКИЙ, Р. В. СВИСТУН, К. Г. ПОЛЯЦКО, О. І. ДЗЮБАНОВСЬКИЙ, М. О. ОНИСЬКІВ
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish their work in Hospital Surgery. Journal by L. Ya. Kovalchuk agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
