{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T04:16:45Z","timestamp":1792556205593,"version":"4.5.0"},"reference-count":32,"publisher":"S. Karger AG","issue":"1","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dig Surg"],"published-print":{"date-parts":[[2024]]},"abstract":"<b><i>Background:<\/i><\/b> Debate exists regarding the optimal treatment for painful chronic pancreatitis (CP). This meta-analysis aims to determine the outcomes of surgical intervention as compared to endoscopy in patients with painful CP. <b><i>Methods:<\/i><\/b> A systematic review and meta-analysis including studies from PubMed, Embase, Web of Science, and Cochrane Databases (1995 onwards) was done by two independent reviewers using PRISMA guidelines. Primary outcome was pain relief. <b><i>Results:<\/i><\/b> Among 8,479 studies, three were randomized trials, comprising a total of 199 patients. Compared with endoscopy, surgery was associated with a lower Izbicki score, both at medium term (mean difference (MD) 21.46, 95% confidence interval (CI) 13.48\u201329.43, <i>p<\/i> &lt; 0.00001) and long term (MD: 17.80, 95% CI: 8.36\u201327.23, <i>p<\/i> = 0.0002). A higher proportion of surgical patients had some sort of pain relief compared with those who had endoscopy, both at medium term (72% vs. 46%, RR: 1.51, 95% CI: 1.19\u20131.90, <i>p<\/i> = 0.0006) and long term (73% vs. 47%, RR: 1.50, 95% CI: 1.19\u20131.89, <i>p<\/i> = 0.0007). Complete pain relief was more common in the surgical group compared to the endoscopy group, both at medium term (33% vs. 17%, RR: 1.97, 95% CI: 1.16\u20133.36, <i>p<\/i> = 0.01) and long term (35% vs. 18%, RR: 1.92, 95% CI: 1.15\u20133.20, <i>p<\/i> = 0.01). The pooled crossover rate from endoscopy to surgery was 22% (22\/99). <b><i>Conclusions:<\/i><\/b> Surgical treatment in patients with painful CP leads to better pain control, requiring fewer interventions as compared to endoscopic treatment.<\/jats:p>","DOI":"10.1159\/000535588","type":"journal-article","created":{"date-parts":[[2024,1,8]],"date-time":"2024-01-08T17:00:31Z","timestamp":1704733231000},"page":"1-11","source":"Crossref","is-referenced-by-count":9,"title":["Surgery versus Endoscopy for the Management of Painful Chronic Pancreatitis: A Systematic Review and Meta-Analysis of Randomized Trials"],"prefix":"10.1159","volume":"41","author":[{"given":"Noel","family":"Cassar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Cromwell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sinead","family":"Duggan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"van 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