Hands off or Hands on for Painful Chronic Pancreatitis: Current Indications for Surgery in Chronic Pancreatitis

There is a lack of consensus regarding the best treatment for chronic pancreatitis (CP). The condition usually presents with pain and, as very little can be done to change the natural history of the disease process, our efforts are directed at improving the quality of life of the patients. The most common associated etiological factor is alcohol addiction or abuse. The personality type of many of these patients makes substance abuse common and this significantly impacts on the success of treatment. A nihilistic approach to this condition based on evidence suggesting that the process burns out in approximately 10 years is difficult to accept when one witnesses the suffering of these patients.