Factors affecting recurrence of pain after surgery for chronic pancreatitis: A retrospective and prospective study.

Abstract

Backgrounds/aims: Postoperative pain recurrence is a challenging issue in chronic pancreatitis (CP). This study explores the incidence and factors contributing to recurrent pain after surgery.

Methods: An ambispective observational study evaluated patients with painful CP undergoing surgery from 2011 to 2022. The intensity frequency consequence (IFC) pain score and the painDETECT questionnaire were utilized to assess pain before and after surgery. Patients were categorized into 2 groups based on their IFC pain scores: a pain group and a pain-free group. Clinical, radiological, surgical, and post-surgical parameters were compared between these groups using the student t-test and logistic regression for continuous and categorical variables, respectively. A p-value of < 0.05 was deemed significant. Multivariate analysis was conducted.

Results: A total of 125 patients were enrolled (pain group, 71 [56.8%]; pain-free group, 54 [43.2%]). In the pain group, 65 experienced mild and 6 experienced moderate pain. The average post-surgery pain score was significantly lower than the pre-surgery score (13.7 vs 2.5, p < 0.001). Multivariate analyses revealed that intravenous (IV) analgesics and preoperative endoscopic interventions were independent predictors of recurrent pain.

Conclusions: The incidence of recurrent pain in CP patients post-surgery was 56.8%, with a significant reduction in pain intensity postoperatively. Patients who required preoperative IV analgesics and underwent endoscopic interventions demonstrated a higher risk of recurrent pain. Neuropathic pain was not identified as a cause of pain recurrence in this study.