Background:
Chronic pancreatitis is a debilitating, life altering disease; however, the long-term outcomes following operative intervention have not been established.
Study Design:
Patients who underwent operative intervention at a single institution between 2000 to 2020 for chronic pancreatitis were included and survival assessed utilizing the National Death Index.
Results:
493 patients who underwent 555 operative interventions for chronic pancreatitis over two decades were included. 48.5% underwent total pancreatectomy ± islet auto transplantation, 21.7% underwent a duodenal preserving pancreatic head resection and/or drainage procedure, 16.2% underwent a pancreaticoduodenectomy, and 12.8% underwent a distal pancreatectomy. The most common etiology of chronic pancreatitis was idiopathic (41.8%), followed by alcohol (28.0%), and known genetic polymorphisms (9.9%). With a median follow-up of 83.9 months, median overall survival (OS) was 202.7 months, with a 5- and 10-year OS of 81.3% and 63.5%. 165 patients were deceased, and the most common causes of death included: infections (16.4%, n=27), cardiovascular disease (12.7%, n=21), and diabetes related causes (10.9%, n=18). On long-term follow-up, 73.1% (n=331) of patients remained opioid free while 58.7% (n=266) were insulin dependent diabetics. On multivariate cox-proportional hazards modeling, only persistent opioid use (HR:3.91 95%CI:2.45-6.24, p<0.01) was associated worse OS.
Conclusion:
Our results represent the largest series to date evaluating long-term survival outcomes in patients with chronic pancreatitis following operative intervention. Our data give insight into the cause of death and allow for the development of mitigation strategies and long-term monitoring of co-morbid conditions.
