Outcome after surgical management of tropical and alcoholic chronic pancreatitis - A Indian tertiary centre experience

Abstract

Background: Chronic pancreatitis (CP) is an inflammatory disease of the pancreas characterized by progressive fibrosis, morphological changes, leading to exocrine and/or endocrine insufficiency. Tropical pancreatitis (TP) is seen mainly in the younger population with large ductal calculi and calcification. In this study, we evaluate the postoperative outcome and pain relief after Frey's and modified Puestow procedure (mPP) in patients of tropical and alcoholic pancreatitis. Materials and Methods: This is a retrospective review of prospectively collected data of surgically treated cases of CP. A total of 44 surgeries were performed with Frey's procedure in 36 (81.82%) patients; and mPP in 8 (18.18%) patients. The pain had been evaluated by the Visual analog scale in preoperatively and at 1 year follow-up. Results: The etiology of CP was related to chronic alcohol use in 16 patients (36.36%) and TP in 28 patients (63.63%). Abdominal pain relief was achieved in 86.36% of the patients. Postoperative pain relief was achieved in 91.66% and 62.5% of patients undergoing Frey's and mPP, respectively. Postoperative pain relief was better in TP (92.86%) as compared to alcoholic pancreatitis (75%) (P = 0.0968). Postoperative major complications over 30 days (Clavein Dindo Grade IIIa and above) were seen in 6.8%. Conclusion: Frey's procedure was associated with better abdominal pain relief as compared to mPP. Patients of tropical CP experience better postoperative pain relief than alcoholic CP.