The Saudi Journal of Medical Insights

Chronic pancreatitis (CP) is a progressive inflammatory disease leading to irreversible fibrosis, pain, and loss of pancreatic
function, presenting a complex therapeutic dilemma. This narrative review aims to synthesize current evidence on the
conservative and surgical strategies for managing CP. A comprehensive literature search was conducted, focusing on
diagnosis, medical therapy, indications for intervention, surgical techniques, and outcomes. The findings underscore that
initial management must be multidisciplinary, centered on strict lifestyle modifications, aggressive pain control, and
pancreatic enzyme replacement. When conservative measures fail, surgical intervention becomes necessary for intractable
pain, suspicion of malignancy, or mechanical complications. Comparative analysis of procedures indicates that duodenumpreserving pancreatic head resections often provide superior long-term outcomes, offering durable pain relief with better
preservation of endocrine function and quality of life compared to traditional resections like pancreatoduodenectomy. The
conclusion emphasizes that treatment must be individualized, integrating escalating medical, endoscopic, and surgical
options within a personalized care framework to optimize patient outcomes. Future research should focus on early disease
detection and refining patient selection for tailored interventions.