Chronic pancreatitis is a debilitating, life altering disease; however, the long-term outcomes following operative intervention have not been established.
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.
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.
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.