Endoscopic vs. Surgical Drainage for Chronic Pancreatitis

At 2 years, surgery patients had lower pain scores and better physical-health scores than did endoscopy patients.

Pancreatic-duct (PD) obstruction is an important etiologic factor for pain in chronic pancreatitis (CP) patients; thus, PD decompression is an appropriate treatment for symptomatic patients with markedly dilated PDs. To compare outcomes of endoscopic and surgical drainage, researchers from Amsterdam enrolled 39 patients with CP, obstruction of the PD (due to strictures, stones, or both), dilation of the PD (≥5 mm proximal to stenosis), and severe recurrent pancreatic pain (not relieved by non-narcotic analgesics). Patients were randomized to endoscopic therapy, consisting of sphincterotomy, pancreatic stone removal (extracorporeal shockwave lithotripsy for stones >7 mm), stricture dilation, and stenting, or to surgical treatment with longit…

Reviewing Author

Stuart Sherman, MD