Z Gastroenterol 2008; 46 - A29
DOI: 10.1055/s-2008-1081536

Hospitalization, frequency of interventions and quality of life after endoscopic, surgical or conservative treatment in patients with chronic pancreatitis

K Rutter 1, A Ferlitsch 1, P Wimmer 2, T Sautner 2, A Püspök 1, P Götzinger 2, A Gangl 1, M Schindl 2
  • 1Department of Internal Medicine III (Division of Gastroenterology and Hepatology)
  • 2Department of Surgery, Medical University of Vienna

Objective: Patients with chronic pancreatitis usually have a long and debilitating history of disease with frequent hospital admissions, episodes of intractable pain and multiple interventions. The primary therapeutic approach may affect the long term outcome of patients with chronic pancreatitis. The aim of this retrospective study is to evaluate whether the selection of initial therapy affects quality of life and determines morbidity and mortality in patients with chronic pancreatitis.

Patients and Methods: 292 patients with different initial therapies were retrospectively analyzed about frequency of interventions, time in hospital, symptom free intervals, morbidity and mortality. Quality of life (QoL) at latest follow up was measured by two standardized quality of life questionnaires (EORTC C30 and PAN26).

Results: Endoscopic treatment was initially performed in 150 (52.4%) patients, whereas 99 (33.9%) underwent surgery and 43 (14.7%) patients were conservatively treated at their presentation. Patients who underwent surgery had a significant shorter time in hospital, fewer subsequent therapies (p! 0.001) and a longer relapse free interval (log Rank: 0.004) compared with endoscopically treated patients. Concerning QoL results, patients after initial surgical treatment showed less symptoms of pain (p=0.057), nausea and vomiting (p=0.036) compared with endoscopically and conservatively treated patients. However, survival was not significant affected by the etiology of pancreatitis or initial kind of treatment.

Conclusion: Different therapeutic options for patients with chronic pancreatitis were compared for the first time regarding long term QoL and hospitalization. Initial surgical treatment was superior regarding consecutive interventions, hospitalization and QoL compared with endoscopic and conservative strategies and should therefore be considered early when initial conservative and endoscopic attempts fail.