Introduction: Chronic pancreatitis is a complex and debilitating disease associated with significant morbidity and reduced quality of life. In many patients, surgery is performed after prolonged periods of medical or endoscopic treatment, which may lead to advanced pancreatic damage and poorer outcomes. Additionally, the choice of surgical procedure often depends on individual patient characteristics and disease patterns, making it important to evaluate the effectiveness of different surgical approaches. This study aims to access the indications and outcomes of surgical interventions in patients with chronic pancreatitis.

Methods and Materials: A prospective observational study of 80 adult patients, undergoing surgical procedures for chronic pancreatitis, was performed in Department of General Surgery of Government Medical College and Hospital, Nagpur for a period of 18 months (From December 2024 to June 2026).

Results: The majority of patients were males (77.5%), with the highest proportion belonging to the 31–40 years age group (27.5%). Most patients originated from rural areas (65.0%). Alcohol consumption and smoking were identified as major risk factors, being present in 70.0% and 60.0% of patients, respectively. Abdominal pain was the universal presenting symptom occurring in all patients (100%). Preoperative endocrine and exocrine dysfunction were observed in 30.0% and 32.5% of patients, respectively. Pancreatic ductal dilatation as the most common radiological finding (72.5%), followed by pancreatic calcifications (62.5%). Intraoperatively, dilated main pancreatic duct (70.0%), dense peripancreatic adhesions (57.5%) and pancreatic calcifications (52.5%) were the predominant findings. The most common indication for surgical intervention was intractable abdominal pain (42.5%), followed by pancreatic ductal obstruction (20.0%). Frey procedure was the most frequently utilized operation (37.5%), followed by lateral pancreaticojejunostomy (27.5%). Complete pain relief was achieved in 60.0% of patients, while an additional 27.5% experienced partial relief, resulting in an overall pain improvement rate of 87.5%. Postoperative complications occurred in 50.0% of patients, with surgical site infection (15.0%) being the most common complication. The majority of patients (45.0%) had a postoperative hospital stay of 8–14 days, and postoperative mortality was low at 2.5%. Postoperatively, new-onset or worsened endocrine and exocrine dysfunction occurred in 12.5% and 15% patients.

Drainage procedures produced superior outcomes. Cyst drainage procedures showed the highest rate of complete pain relief (75.0%) and the lowest complication rate (25.0%), followed by lateral pancreaticojejunostomy, which achieved complete pain relief in 63.6% of patients with a complication rate of 40.9%. Patients undergoing early surgery demonstrated significantly betteroutcomes than those undergoing delayed surgery in terms of complete pain relief, postoperative complications, and prolonged hospital stay.

Conclusion: Chronic pancreatitis requiring surgery predominantly affects middle-aged males with significant exposure to risk factors such as alcohol consumption and smoking. Abdominal pain was identified as the universal and most significant clinical feature, reinforcing its central role as the primary indication for surgical intervention. Organ-preserving and drainage procedures, particularly the Frey procedure and lateral pancreaticojejunostomy, constitute the mainstay of surgical treatment and are associated with favorable outcomes with complete pain relief, acceptable complication rates and effectively preserving pancreatic function in the majority of patients. Early surgery was significantly associated with superior pain relief, lower complication rates, and shorter hospital stay. These findings strongly support a shift toward earlier surgical management in appropriately selected patients, rather than prolonged conservative or endoscopic treatment in the face of persistent symptoms.

KEYWORDS: Chronic Pancreatitis, Drainage Procedures, Longitudinal Pancreaticojejunostomy, Frey procedure, Resection Procedures.