Marek Škorňa1, Marie Přecechtělová2, Anna Žáková2, Zdeněk Kala3, Petr Dítě4,5
Introduction: The therapy of chronic pancreatitis is mainly the therapy of pancreatic symptom; the most frequent symptoms are pain and pancreatic malabsorption. Therapy of chronic pancreatitis is divided into three modifications: a/ conservative therapy, b/ endoscopic, c/ surgical. Treatment effectiveness is evaluated according to subjective clinical symptoms, predominantly according to pain, influencing of body weight and in the area of psychosocial to the standardized questionnaire of quality of life EORTC QLQ-C3O. The aim of our work was to compare various therapeutic procedures and their impact on the quality of life of patients with chronic pancreatitis, including long-term or surgical treatment. Material and method: 66 patients who were monitored at IGEK, surgical clinic TH Brno and II internal clinic of TH USA were questioned. Patients were divided to a group treated conservatively (dietotherapy and medicament), endoscopically and surgically (resection or drainage performance). Overall 30 questions and answers were evaluated as troubles at physical exertion, limitation of working operations, psychical influencing of health stage or influencing of patients in their daily activities. To the evaluation of the overall quality of life we added the results of our work which evaluated surgical and endoscopic therapy in 72 randomized patients in the scope of 1 year, 3 years and 5 years after completion of treatment and impact on pancreatic pain and body weight were evaluated. Results: Evaluation of the quality of life by the questionnaire QLQ-C3O proved that endoscopic therapy as well as surgical treatment leads to improvement of the quality of life, in some areas statistically significant or on the threshold of importance. The impact on clinical symptoms is, within the interval of 5 years after surgical therapy, more successful than endoscopic treatment, especially when clearence or lowering of the intensity of pancreatic pain appears. Lowering of human body weight in the view of particular long-term results was higher than after surgical treatment. Conclusion: Correct indication and timing of the therapy modifications for chronic pancreatitis will significantly influence the quality of life as well as main clinical symptoms of patients with chronic algic pancreatitis.