Pain relapses in the first 10 years of chronic pancreatitis

Purpose To evaluate whether the annual number of pain relapses of chronic pancreatitis correlated with sex, type of pancreatitis, drinking and smoking, presence of intraductal calcifications, pancreaticojejunostomy, and length of follow-up in the first 10 years of follow-up. Methods The authors analyzed 205 nonobstructive chronic pancreatitis cases with at least a 10- year follow-up, for a total of 2,034 person/year observations. Data were recorded on the daily number of cigarettes smoked and grams of alcohol drunk, as well as the presence of intraductal calcifications, and performance of pancreaticojejunostomy. Results The model for multivariate autoregressive repeated measures analysis indicated that drinking (P<0.0001), smoking (P<0.0001), calcifications (P<0.0001), pancreaticojejunostomy (P<0.0011), and length of follow-up (P<0.0001) all correlated significantly with annual number of pain relapses. Pancreaticojejunostomy is probably very effective in reducing pain both physically, by removing the largest intraductal calcifications and obstructions through drainage of Wirsungʹs duct, and psychologically, by inducing patients to cut down their postsurgical alcohol intake. Conclusions Regardless of surgical treatment, patients should be advised to reduce both their alcohol intake and cigarette smoking.