A comparative study on Quality of life, between Primary Early Surgery and Late surgery in Chronic Calcific Pancreatitis using the SF-36 Questionnaire – A Prospective Observational Cohort Study

Abstract Purpose: We aim to test the hypothesis that “Primary Early surgery (i.e. within 2years from symptoms onset) in Chronic calcific pancreatitis (CCP) has better durable long-term Quality of Life (QOL) than patients undergoing late surgery (> 2 years from symptom onset)” using the SF 36 Questionnaire. Methods: This is a prospective observational study conducted between 2016 to 2025. 162 patients with large duct CCP (MPD diameter ≥ 6mm) underwent either Frey’s procedure or Lateral Pancreatico Jejunostomy. 62/162 patients on regular follow up were included in the study. The 62 patients were grouped into Primary early surgery group (PESG) and Late surgery group (LSG). After long term (> 3year) of follow up, patient’s responses regarding QOL were recorded using the SF36 questionnaire and compared. The primary outcome measures were pain, physical functioning and role limitations due to physical health and the other components on the SF 36 were taken as secondary outcome measures. Results:27/62 cases were in LSG and 35/62 belonged to PESG. Mann-Whitney U test was used to make group comparisons. 7 out of 8 components namely Pain, Physical Functioning, Role Limitations Due to Physical Health, Role Limitations Due to Emotional Problems, Energy/ Fatigue, Emotional Well Being, Social Functioning had statistically significant difference favouring better QOL in PESG. Conclusion: Primary Early surgery has a positive impact on long term QOL in patients with CCP. However, future RCTs will help to draw solid conclusions to support or refute our observations.