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Patients with chronic pancreatitis, dilated ducts, and chronic abdominal pain often are treated endoscopically because the procedure is less invasive than surgery. In a recent randomized trial in which the two approaches were compared in 88 patients (mean age, 54) in the Netherlands, pain relief was somewhat better in the surgery group at 18 months, but the results were not compelling (NEJM JW Gen Med Feb 15 2020 and JAMA 2020; 323:237). The same group now reports results after mean follow-up of 98 months.
In intent-to-treat analysis, pain relief and patient satisfaction were greater with surgical than with endoscopic treatment. Overall quality of life and markers of disease progression did not differ between the groups. About half of the en…