What is the most common indication for surgery in chronic pancreatitis patients?

The most common indication for surgery in patients with chronic pancreatitis is intractable pain. Chronic pancreatitis often leads to persistent and severe abdominal pain that can significantly impair a patient's quality of life. When conservative management, including pain control through medications and lifestyle modifications, fails to provide adequate relief, surgical intervention becomes a relevant option.

Surgical procedures, such as pancreatic resection or drainage procedures, aim to alleviate pain either by removing the damaged portions of the pancreas or addressing complications such as a pseudocyst. Relief of intractable pain is the primary motivation for surgical intervention, as it directly impacts the patient's daily functioning and overall well-being.

While weight loss, exocrine deficiency, and the risk of cancer are associated concerns in chronic pancreatitis, they are not the primary reasons for surgical intervention. Weight loss may occur due to multiple factors including pain leading to decreased oral intake, but addressing pain remains the priority. Similarly, while exocrine deficiency can be managed with enzyme replacement, it does not commonly necessitate surgery. Cancer risk is certainly increased in chronic pancreatitis, but routine surgery is not typically performed solely for cancer prevention unless there are specific indications like lesions or evidence of malignancy.