Amy Norton HealthDay Reporter
TUESDAY, Jan. 24, 2023 (HealthDay News) — Many people who undergo surgery for chronic pancreatitis continue to have health problems afterward, some die young, new study finds became.
The study, conducted at a U.S. medical center, is the largest to look at overall survival several years after surgery for chronic pancreatitis.
They also found that despite the high short-term survival rate, more than a third of patients died within 10 years after surgery, often at an early age.
The median age at death for patients who died was approximately 50 years. So half are younger than that.
Experts say the findings highlight how serious chronic pancreatitis is and how important it is for patients to receive long-term care after surgery.
Gregory Wilson, Ph.D., principal investigator and assistant professor of surgery at the University of Cincinnati, Ohio School of Medicine, said:
Instead, patients require ongoing care for physical health conditions such as diabetes, and often psychological counseling and addiction care.
The pancreas is a vital organ that produces enzymes that aid digestion and hormones that regulate blood sugar levels. Chronic pancreatitis involves ongoing inflammation that disrupts the normal functioning of the organ.
Its causes are varied and sometimes unknown, but long-term heavy drinking is one of the major causes. Smoking is also a risk factor. Some cases are associated with inherited genetic mutations.
This condition also causes various problems. People may need to take digestive enzymes to manage weight loss and diarrhea, and many develop diabetes. But perhaps the most debilitating symptom is chronic abdominal pain. This means that many patients have been on pain relievers for years.
If these measures are inadequate, surgery to remove part or all of the pancreas may eventually be recommended.
“By the time patients come to see us, it’s not uncommon for them to be dependent on opioids just to get through the day,” Wilson said.
Surgery can often relieve pain and improve people’s quality of life, he noted.
But that’s not the end of the story, as new research highlights.
Findings—published on January 24 in. Journal of the American College of Surgeons — Based on 493 patients undergoing surgery for chronic pancreatitis. All were treated at the Cincinnati Medical Center between her 2000 and her 2020.
Overall, more than 95% were still alive one year after surgery. But ten years later, his survival rate had dropped to 63%, even though most patients were middle-aged at the time of surgery.
Wilson’s team also found that despite the severity of the disease, many patients continued to smoke (38%) or abuse alcohol (16%) years after surgery. And he was still taking opioids daily for a quarter.
Infections were the most common cause of death, followed by complications from heart disease, stroke and diabetes. Wilson said it’s surprising that infections are so high on the list, and it’s not clear why. He speculated that it was possible.
Less than 10% of deaths were due to substance abuse, and 6 patients died by suicide.
Emily Winslow, M.D., chief of hepatopancreaticobiliary surgery at MedStar Georgetown University Hospital in Washington, DC, said:
Winslow, who was not involved in the study, agreed that patients need long-term care for various aspects of the disease. This includes continuing to smoke and drink alcohol, and supporting psychological counseling.
She noted that although the number of suicide deaths in the study was relatively small, “it should be on everybody’s radar.” may be associated with severe pain?
The difficulty, according to Winslow, is that there is no “quarterback” on the medical team for chronic pancreatitis. That’s unlike cardiology, for example, where a cardiologist is typically the leader.
Winslow said the surgical team typically managed care for several months after surgery. Patients can also see an endocrinologist to get a diabetes management plan. But usually no one coordinates the big picture.
“Patients need psychosocial support and care after surgery,” Wilson said. “I wonder if that’s the piece we’re missing.”
Both doctors emphasized that patients with chronic pancreatitis should not be afraid of surgery. Many patients have since recovered well — and he noted that the problems surrounding the disease are not solved by avoiding surgery.
Instead, the system needs to do a better job of meeting the patient’s needs.
The National Institute of Diabetes and Digestive and Kidney Diseases is doing more research on chronic pancreatitis.
Source: Gregory Wilson, M.D., Ph.D., Assistant Professor of Medicine, University of Cincinnati, Ohio. Emily Winslow, MD, Chief, Hepatopancreaticobiliary Surgery, MedStar Georgetown University Hospital, Washington, DC; Journal of the American College of Surgeons, Online January 24, 2023
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