Surgical Outcomes and Trends for Chronic Pancreatitis: An Observational Cohort Study from a High-Volume Centre.
Poya GhorbaniRimon DankhaRosa BrissonMelroy A D'SouzaJohannes Matthias LöhrErnesto SparrelidMiroslav VujasinovicPublished in: Journal of clinical medicine (2022)
Surgery for chronic pancreatitis (CP) is considered as a last resort treatment. The present study aims to determine the short- and medium-term outcomes of surgical treatment for CP with a comparison between duodenum-preserving pancreatic head resection (DPPHR) and pancreatoduodenectomy (PD). The trends in surgical procedures were also examined. This was a retrospective cohort study of patients who underwent surgery for CP between 2000 and 2019 at the Karolinska University Hospital. One hundred and sixty-two patients were included. Surgery performed included drainage procedures ( n = 2), DPPHR ( n = 35), resections ( n = 114, of these PD in n = 65) and other procedures ( n = 11). Morbidity occurred in 17%, and the 90-day mortality was 1%. Complete or partial pain relief was achieved in 65% of patients. No significant difference in morbidity was observed between the DPPHR and PD groups: 17% vs. 20% ( p = 0.728). Pain relief did not differ between the groups (62% for DPPHR vs. 73% for PD, p = 0.142). The frequency of performed DPPHR decreased, whereas the rate of PD remained unaltered. Surgical treatment for CP is safe and effective. DPPHR and PD are comparable regarding post-operative morbidity and are equally effective in achieving pain relief. Trends over time revealed PD as more commonly performed compared to DPPHR.
Keyphrases
- end stage renal disease
- minimally invasive
- chronic pain
- newly diagnosed
- chronic kidney disease
- ejection fraction
- pain management
- prognostic factors
- type diabetes
- adipose tissue
- cardiovascular events
- single cell
- acute coronary syndrome
- insulin resistance
- weight loss
- smoking cessation
- combination therapy
- percutaneous coronary intervention
- replacement therapy
- preterm birth
- optical coherence tomography
- glycemic control