Endoscopic or surgical intervention for painful obstructive chronic pancreatitis
Endoscopy and surgery are the treatments of choice in patients with chronic pancreatitis and a dilated pancreatic duct. In this review we compared these two intervention modalities. We found that surgery achieved pain relief in a higher proportion of patients than with endoscopy. Surgery also had other advantages like improved quality of life and reduced risk of developing exocrine pancreatic insufficiency. The studies seemingly showed no difference in complications after intervention between endoscopy and surgery, but lacked the power to establish this with sufficient reliability. We also compared surgery to conservative treatment. Results of one trial suggested that surgery early in the disease achieved better pain relief and preservation of pancreatic function. The trial, however, was small, which precluded drawing reliable conclusions.