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Operative management of chronic pancreatitis: A review

      Highlights

      • Pain secondary to chronic pancreatitis is a difficult clinical problem to manage.
      • Surgical intervention is often reserved for those who have failed to gain adequate pain relief from a more conservative approach.
      • Operative management of chronic pancreatitis can improve quality of life with low rates of morbidity and mortality.
      • This article summarizes current surgical therapies for chronic pancreatitis.

      Abstract

      Background

      Pain secondary to chronic pancreatitis is a difficult clinical problem to manage. Many patients are treated medically or undergo endoscopic therapy and surgical intervention is often reserved for those who have failed to gain adequate pain relief from a more conservative approach.

      Results

      There have been a number of advances in the operative management of chronic pancreatitis over the last few decades and current therapies include drainage procedures (pancreaticojejunostomy, etc.), resection (pancreticoduodenectomy, etc.) and combined drainage/resection procedures (Frey procedure, etc.). Additionally, many centers currently perform total pancreatectomy with islet autotransplantation, in addition to minimally invasive options that are intended to tailor therapy to individual patients.

      Discussion

      Operative management of chronic pancreatitis often improves quality of life, and is associated with low rates of morbidity and mortality. The decision as to which procedure is optimal for each patient should be based on a combination of pathologic changes, prior interventions, and individual surgeon and center experience.

      Keywords

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