Long-term follow-up results of surgery for chronic pancreatitis

Background/Aims: Based on a mean follow-up period of 86 months, the long-term results of 87 drainage and resection operations performed for chronic pancreatitis between 1990-94 were evaluated. Methodology: To evaluate the results, two questionnaires were filled out by the patients. The first was related to the pancreatitis and the long-term complications, the second was a Gastrointestinal Quality of Life Index questionnaire. Data of deceased patients were collected with the help of general practitioners. Results: Based on the analysis of disease-related and quality of life questionnaire forms only 34% of the investigated patients could be classified as a group showing good results. There was a high incidence of long-term mortality (25%). Eighty-three percent of the deceased patients (18 patients) died after the seventh postoperative year. The most threatened group seems to be the alcoholic and insulin-dependent diabetic one. The combination of the two pathologies was the cause of death in a third of the cases. Insulin-dependent diabetes mellitus developed in 13 patients after an average of 3.9 years following surgery, mainly as a consequence of the irreversible and progressive nature of disease. The rate of disability was 51%. No significant difference could be demonstrated between the resected and the decompressed group according to either disability or late mortality rate. Conclusions: Based on these results, the authors wish to emphasize that in chronic pancreatitis the short-term follow-up results may be deceptive, and that the real outcome of the surgical treatment can only be expected five years following surgery.