Early surgery was better than endoscopy in managing chronic pancreatitis-related pain, with no appreciable difference in the complications linked with the treatment.

A systematic review and meta-analysis was carried out to explore endoscopy versus early surgery to manage chronic pancreatitis.

In order to find out studies that compared endoscopy and surgery to alleviate chronic pancreatitis symptoms, a literature search was performed on online databases. Complications, pain alleviation, and exocrine/endocrine insufficiency were the key endpoints of interest. The mean number of operations and the average length of stay were secondary endpoints. Utilizing a random-effects model with 95% confidence interval, the pooled odds ratio (OR) was obtained.

Two retrospective studies and three randomized controlled trials involving 602 volunteers (71.4% men) were found to be eligible out of 9880 publications that were reviewed. In total, 317 patients had endoscopic treatments, while 285 patients had early surgery. In comparison to endoscopy, early surgery considerably reduced discomfort (OR 0.46; I2 = 17.65%) and needed fewer operations (mean difference 1.66; I2 = 96.46%).

Procedure-related complications (OR 0.91; I2 = 38.8%), endocrine (OR 1.18; I2 = 28.24%) or exocrine  (OR 1.18; I2 = 38.8%) insufficiency, or duration of stay (mean difference 1.21) did not differ significantly from one another.

For the management of chronic pancreatitis, early surgery exhibited better outcomes than endoscopy.