Comparative analysis of early outcomes in laparoscopic and open surgery for chronic pancreatitis: a retrospective study
摘要
Surgery is the cornerstone of pain management in chronic pancreatitis, especially in patients with a dilated pancreatic duct. Lateral pancreaticojejunostomy and the Frey procedure are commonly employed decompressive techniques, performed via either open or laparoscopic approaches. This study compares postoperative outcomes and pain relief between the two approaches. In this retrospective study, 100 patients with chronic pancreatitis and a dilated main pancreatic duct (≥ 5 mm) underwent either lateral pancreaticojejunostomy or Frey procedure between 2020 and 2024. Patients with suspected malignancy, history of endoscopic therapy, or requiring pancreatic resection were excluded. Of the total, 69 underwent open surgery and 31 underwent laparoscopic surgery. Pain was assessed using visual analogue scale and Izbicki scores preoperatively and at 6 months. Demographic, surgical, and postoperative parameters were recorded and analysed. Baseline characteristics and preoperative pain scores were similar between the groups. The laparoscopic group had a longer operative time (230 ± 20 vs. 198 ± 18 min; p < 0.001) but lower intraoperative blood loss (128 ± 46 vs. 149 ± 46 mL; p = 0.02). Complication rates (12.9% vs. 18.8%; p = 0.53) and hospital stay (5 vs. 6 days; p = 0.26) were comparable. Both groups showed significant pain relief at 6 months. Residual visual analogue scale scores were slightly lower in the laparoscopic group (11 ± 7 vs. 17 ± 10; p = 0.002). Laparoscopic surgery for chronic pancreatitis is as safe and effective as open surgery, offering comparable pain relief with reduced blood loss. It is a safe and viable option in selected patients.