Recent re-evaluation of the natural course of chronic pancreatitis has suggested that many patients do not experience pain alleviation with progressive "burning out" of the organ. Thus, therapeutic nihilism is not warranted in chronic pancreatitis, especially because criteria to select those patients becoming eventually pain-free do not exist. Concurrently, many new therapeutic options have emerged, such as endoscopic interventions combined with extracorporeal shock wave lithotripsy and modern organ-sparing surgical procedures. This article reviews the background and results of these modern surgical alternatives to classical drainage and resection procedures with special regard to duality of life, which turns out to be the crucial endpoint for the patient.
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