Tags

Type your tag names separated by a space and hit enter

Surgery for chronic pancreatitis: the role of early surgery in pain management.
Pancreas 2015; 44(5):819-23P

Abstract

OBJECTIVES

To examine if surgery performed for pain of chronic pancreatitis (CP) within 3 years diagnosis has greater odds of achieving complete pain relief than later surgery and to find optimal surgical timing for attaining pain relief in CP.

METHODS

Retrospective review of records at a tertiary institution 2003 to 2011 for CP where the operative indication was pain. Outcomes were pain-free status, opioid use, and pancreatic insufficiency at 3-year follow-up. Univariate analysis by Fisher exact tests. Receiver operating curve to calculate cutoff threshold time for surgery.

RESULTS

Outcomes for 66 patients were included. Median preoperative CP duration was 28 months (interquartile range, 12, 67). Twenty-six patients (39.4%) were free of pain at the 3-year follow-up. Thirty-four patients (51.5%) were opioid users at follow-up. Postoperatively, 34 patients (51.5%) demonstrated endocrine, and 32 patients (48.5%) demonstrated exocrine insufficiency. The optimal cutoff point for preoperative CP duration was 26.5 months (area under the curve, 0.66). Shorter duration of CP before surgery was a predictor of pain-free status and reduced postoperative opioid use at follow-up.

CONCLUSIONS

Results from a single institution analysis suggest early surgical intervention of 26.5 months or less of diagnosis is associated with improved pain control, and optimal timing for surgery may be earlier than previously thought.

Authors+Show Affiliations

From the *Surgical Outcomes Analysis and Research, Beth Israel Deaconess Medical Center and Harvard Medical School; †Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, MA; and ‡Department of Surgery, University of Pennsylvania, Philadelphia, PA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25882695

Citation

Yang, Catherine J., et al. "Surgery for Chronic Pancreatitis: the Role of Early Surgery in Pain Management." Pancreas, vol. 44, no. 5, 2015, pp. 819-23.
Yang CJ, Bliss LA, Freedman SD, et al. Surgery for chronic pancreatitis: the role of early surgery in pain management. Pancreas. 2015;44(5):819-23.
Yang, C. J., Bliss, L. A., Freedman, S. D., Sheth, S., Vollmer, C. M., Ng, S. C., ... Tseng, J. F. (2015). Surgery for chronic pancreatitis: the role of early surgery in pain management. Pancreas, 44(5), pp. 819-23. doi:10.1097/MPA.0000000000000333.
Yang CJ, et al. Surgery for Chronic Pancreatitis: the Role of Early Surgery in Pain Management. Pancreas. 2015;44(5):819-23. PubMed PMID: 25882695.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Surgery for chronic pancreatitis: the role of early surgery in pain management. AU - Yang,Catherine J, AU - Bliss,Lindsay A, AU - Freedman,Steven D, AU - Sheth,Sunil, AU - Vollmer,Charles M, AU - Ng,Sing Chau, AU - Callery,Mark P, AU - Tseng,Jennifer F, PY - 2015/4/18/entrez PY - 2015/4/18/pubmed PY - 2016/4/8/medline SP - 819 EP - 23 JF - Pancreas JO - Pancreas VL - 44 IS - 5 N2 - OBJECTIVES: To examine if surgery performed for pain of chronic pancreatitis (CP) within 3 years diagnosis has greater odds of achieving complete pain relief than later surgery and to find optimal surgical timing for attaining pain relief in CP. METHODS: Retrospective review of records at a tertiary institution 2003 to 2011 for CP where the operative indication was pain. Outcomes were pain-free status, opioid use, and pancreatic insufficiency at 3-year follow-up. Univariate analysis by Fisher exact tests. Receiver operating curve to calculate cutoff threshold time for surgery. RESULTS: Outcomes for 66 patients were included. Median preoperative CP duration was 28 months (interquartile range, 12, 67). Twenty-six patients (39.4%) were free of pain at the 3-year follow-up. Thirty-four patients (51.5%) were opioid users at follow-up. Postoperatively, 34 patients (51.5%) demonstrated endocrine, and 32 patients (48.5%) demonstrated exocrine insufficiency. The optimal cutoff point for preoperative CP duration was 26.5 months (area under the curve, 0.66). Shorter duration of CP before surgery was a predictor of pain-free status and reduced postoperative opioid use at follow-up. CONCLUSIONS: Results from a single institution analysis suggest early surgical intervention of 26.5 months or less of diagnosis is associated with improved pain control, and optimal timing for surgery may be earlier than previously thought. SN - 1536-4828 UR - https://www.unboundmedicine.com/medline/citation/25882695/Surgery_for_chronic_pancreatitis:_the_role_of_early_surgery_in_pain_management_ L2 - http://Insights.ovid.com/pubmed?pmid=25882695 DB - PRIME DP - Unbound Medicine ER -