PTU-72 Outcomes of surgery for chronic pancreatitis in the manchester specialist multi-disciplinary pancreatitis service

IntroductionThe management of chronic pancreatitis is complex. In Manchester, a multi-disciplinary approach to care has been in place since 1999. Patients are assessed by specialist pancreatologists, surgeons, and dietitians with a consensus approach toward endoscopic intervention as a first step. This study reports the outcome of surgery in patients managed by this approach.MethodsA retrospective database searches to identify all patients having pancreatic surgery for chronic pancreatitis (CP) in the Manchester Royal Infirmary) over a 20-year period from 1999-2019. Patients were excluded from the study if final histology revealed cancer.Results20 patients were identified; mean (range) age in years 49 (18-80). Sixteen (80%) were male. Alcohol was the cause in 10, 3 were idiopathic with the remainder including genetic, auto-immune, and pancreas divisum. Nineteen had undergone prior endoscopic intervention. Ten patients underwent Whipple pancreatoduodenectomy, nine underwent longitudinal pancreatojejunostomy with partial head resection and there was one distal pancreatectomy. Hospital stay ranged from 6 to 32 days with a mean of 15 days. There was no operative mortality. Pancreatic exocrine insufficiency was documented in 60% before surgery and in 85% after. Diabetes was present in 55% before surgery and in 65% after.ConclusionMultidisciplinary assessment is the key to the selection of patients to undergo surgery for chronic pancreatitis. In this selected population, surgery can be undertaken safely with low mortality.