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Long-Term Outcomes Explored After Chronic Pancreatitis Surgery

Ten-year overall survival is 63.5 percent; only persistent opioid use associated with worse overall survival in multivariable modeling

By Elana Gotkine HealthDay Reporter

WEDNESDAY, Feb. 15, 2023 (HealthDay News) — Ten-year overall survival is 63.5 percent among patients undergoing operative intervention for chronic pancreatitis, according to a study published online Jan. 24 in the Journal of the American College of Surgeons.

Gregory C. Wilson, M.D., from the University of Cincinnati College of Medicine, and colleagues examined survival among patients who underwent operative intervention at a single institution between 2000 and 2020 for chronic pancreatitis. Data were included for 493 patients who underwent 555 operative interventions: 48.5 percent underwent total pancreatectomy ± islet auto transplantation.

The most common etiology of chronic pancreatitis was idiopathic, followed by alcohol and known genetic polymorphisms (41.8, 28.0, and 9.9 percent, respectively). With a median follow-up of 83.9 months, the researchers found that median overall survival was 202.7 months, with a five- and 10-year overall survival of 81.3 and 63.5 percent. A total of 165 patients were deceased, with infections, cardiovascular disease, and diabetes-related causes the most common causes of death (16.4, 12.7, and 10.9 percent, respectively). Overall, 73.1 percent of the patients remained opioid-free on long-term follow-up and 58.7 percent had insulin-dependent diabetes. Only persistent opioid use was associated with worse overall survival in multivariate Cox-proportional hazards modeling (hazard ratio, 3.91).

“There’s more than just surgery in the care of these patients,” Wilson said in a statement. “There’s a second part to all of this and the study highlights some of these findings that are important, such as the diabetic-related causes of death, cardiovascular disease, even some of the cancers that show up.”

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