Outcomes of Resection Versus Drainage Procedures in ChronicPancreatitis: A Prospective Cohort Analysis

Background: Chronic pancreatitis is marked by intractable pain and progressive exocrine and endocrineinsufficiency. When conservative measures fail, surgical intervention—either resectional (e.g., Frey’s procedureor distal pancreatectomy) or drainage (e.g., lateral pancreaticojejunostomy)—is indicated, but comparative dataare limited.Objectives: To compare pain relief, quality of life, and perioperative outcomes between resectional and drainageprocedures in chronic pancreatitis.Methods: In this prospective cohort study, 100 patients with chronic pancreatitis refractory to medical therapywere enrolled Surgery from Jan 2021 to December 2021 and allocated to resectional surgery (n = 50) or drainagesurgery (n = 50) according to ductal anatomy and surgeon assessment. Pain was measured preoperatively and at12 months using the Izbicki pain score (0–100; higher = worse). Quality of life was assessed at 12 months withthe EORTC QLQ-PAN26 (0–100; higher = better). Secondary outcomes included operative time (minutes),intraoperative blood loss (mL), length of hospital stay (days), and overall complication rate. Continuous variableswere compared by independent-samples t-test and categorical variables by chi-square test; p ≤ 0.05 wassignificant.Results: Baseline Izbicki scores were similar (resection 72.3 ± 9.8 vs. drainage 71.1 ± 10.5; p = 0.62). At 12months, resectional patients achieved greater pain reduction (mean score 18.5 ± 12.2) than drainage patients (27.8± 15.4; p = 0.003). Mean QLQ-PAN26 scores favored resection (82.1 ± 7.4 vs. 75.6 ± 9.1; p = 0.001). Operativetime was longer for resection (210 ± 35 min) versus drainage (150 ± 28 min; p < 0.001), with higher blood loss(320 ± 85 mL vs. 180 ± 60 mL; p < 0.001). Length of stay did not differ significantly (resection 8.2 ± 2.1 days vs.drainage 7.6 ± 1.9 days; p = 0.12). Overall complication rates were comparable (resection 18% vs. drainage 14%;p = 0.54).Conclusion: Resectional surgery provided superior long-term pain relief and quality-of-life improvementcompared with drainage procedures, albeit with longer operative times and greater blood loss. Both approachesdemonstrated acceptable safety profiles. Patient selection based on ductal anatomy and surgical risk remainsessential.