Hospitalization, Frequency of Interventions, and Quality of Life after Endoscopic, Surgical, or Conservative Treatment in Patients with Chronic Pancreatitis View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2010-07-20

AUTHORS

Karoline Rutter, A. Ferlitsch, T. Sautner, A. Püspök, P. Götzinger, A. Gangl, M. Schindl

ABSTRACT

ObjectivePatients with chronic pancreatitis usually have a long and debilitating history of disease with frequent hospital admissions, episodes of intractable pain and multiple interventions. The sequences of treatment at initial presentation, endoscopy, surgery, or conservative treatment may affect the time course and admissions needed for disease control, thereby determining quality of life and overall outcome.MethodsA total of 292 patients with initial endoscopic, surgical, or conservative pharmacological treatment were retrospectively analyzed regarding frequency of interventions, days in hospital, symptom-free intervals, morbidity, and mortality. Quality of life (QoL) at the latest follow-up was measured by two standardized quality of life questionnaires (EORTC C30 and PAN26).ResultsEndoscopic treatment was initially performed in 150 (51.4%) patients, whereas 99 (33.9%) underwent surgery and 43 (14.7%) patients were treated conservatively at their initial presentation. Patients who underwent surgery had a significantly shorter time in the hospital (25.3 ± 24.6, 34.4 ± 35.1, 61.1 ± 37.9; P < 0.001), fewer subsequent therapies (0.43 ± 1.0, 2.1 ± 2.4, 3.1 ± 3.0; P ≤ 0.001), and a longer relapse-free interval (P = 0.004) compared with endoscopically treated patients. The overall complication rate was 32% both after surgery and endoscopy. Infectious-related complications occurred more often after surgical treatment (P ≤ 0.001), whereas patients after endoscopic intervention developed acute or chronic pancreatitis or pseudocyst formation (P = 0.023).ConclusionsPatients who undergo surgery as their initial treatment for chronic pancreatitis require less consecutive interventions, a shorter hospital stay, and have a better quality of life compared with any other treatment. Surgery should therefore be considered early for the treatment of chronic pancreatitis, when endoscopic or conservative treatment fails and patients require further intervention. More... »

PAGES

2642-2647

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00268-010-0713-z

DOI

http://dx.doi.org/10.1007/s00268-010-0713-z

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1020768958

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/20645098


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