Endoscopy versus early surgery for the management of chronic pancreatitis: a systematic review and meta-analysis

Boregowda, Umesha; Echavarria, Juan; Umapathy, Chandraprakash; Rosenkranz, Laura; Sayana, Hari; Patel, Sandeep; Saligram, Shreyas

doi:10.1007/s00464-022-09425-1

Cited by 7 publications

(9 citation statements)

References 28 publications

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“…The reference population here consisted of 382 (44%) patients who completed the EORTC QLQ‐C30 questionnaire a median of two 1–39 years after their diagnosis. The two groups did not differ in age, sex, alcohol or by aetiology but the reference population had a shorter disease duration ( p < 0.001) and more smoking ( p = 0.029).…”

Section: Resultsmentioning

confidence: 99%

“…This could be due to delayed surgery because of prior endoscopic procedures. Hence, it is important to identify those patients likely to benefit from endoscopy or need early surgery for CP as earlier studies have shown that early surgery yields good results in relieving pain 13,28 …”

Section: Discussionmentioning

confidence: 99%

“…Symptomatic pancreatic strictures, duct stones and pancreatic leaks can be treated with endoscopic pancreatic duct stenting 31 . Pancreatic duct stenting can offer pain relief in duct strictures in up to 90% in the short term, but in the long‐term surgery may yield a better result 28,32,33 …”

Section: Discussionmentioning

confidence: 99%

“…Hence, it is important to identify those patients likely to benefit from endoscopy or need early surgery for CP as earlier studies have shown that early surgery yields good results in relieving pain. 13,28 We cannot truly know why the EP group had better QoL than the patients needing no interventions. This could be because of patients being content that their pain and symptoms subsided due to the endoscopic procedures.…”

Section: Quality Of Lifementioning

confidence: 99%

“…31 Pancreatic duct stenting can offer pain relief in duct strictures in up to 90% in the short term, but in the longterm surgery may yield a better result. 28,32,33 Even though the EP patients used more opioids than the reference population, the number of patients with constant pain was the same as that in the reference population. In a recent study it was found that pain was independent on disease duration but did seem to decrease over time, probably due to medical treatment and interventions.…”

Section: Pancreatic Stenting and Painmentioning

confidence: 99%

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Quality of life after endoscopic procedures for chronic pancreatitis: A multicentre study

Parhiala,

Nøjgaard,

Bartholdy

et al. 2023

UEG Journal

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BackgroundChronic Pancreatitis (CP) causes morphological changes in the pancreatic tissue, leading to complications and pain, which may require endoscopic interventions.ObjectiveOur aim was to determine the frequency of endoscopic procedures (EP) in CP patients and to analyse pain and quality of life (QoL) in these patients after their EP.MethodsThis study included 1327 CP patients from the Scandinavian Baltic Pancreatic Club (SBPC) database including four countries and eight centres. We analysed patients undergoing EPs and gathered information on the EP, pancreatic function, pain, disease and duration. The EORTC C‐30 QoL questionnaire was gathered prospectively and multivariable analysis was conducted on independent parameters between the groups. The reference population had no interventions (n = 870).Results260 CP patients (22%) underwent EPs, median one year (range 0–39 years) after CP diagnosis. 68% were males. The median age was 59 (20–90) years. Most common aetiological factors were alcohol in 65% and smoking in 71%. Extracorporeal shock wave lithotripsy (ESWL) was used in 6% of the CP population and in 21% of the EP group. Biliary duct stenting was performed on 37% and pancreatic stenting was performed on 56% of the patients. There was no difference in pain patterns between patients who had pancreatic stenting and the reference population. The EP group had slightly better QoL (p = 0.047), functioning and fewer symptoms than the reference population, in the multivariable analysis there was no interaction effect analysis between the groups. The pancreatic stent group had better QoL and the same amount of pain than the reference group. The patients who needed later surgery (23%) had more pain (p = 0.043) and fatigue (p = 0.021).ConclusionsOne in five of the CP patients underwent EP. These patients scored higher on QoL responses and had better symptom scores. CP patients who had pancreatic stenting performed had the same pain patterns as the reference population. Randomised prospective trials are needed to determine the effect of endoscopy procedures on CP patients.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%