When to Change from Conservative to Surgical Management in Alcoholic Chronic and Tropical Chronic Pancreatitis

This chapter uses the evidence from the literature to present at the outset that, although there exist different proposed etiological features for chronic pancreatitis (CP) such as alcohol and tropical pancreatitis, the individual pathogenetic mechanisms in different forms of CP eventually converge to a single common pathway-the "surgical stage" of CP. Thus, the eventual clinical effects of pancreatic damage in CP manifest similarly and hence the indications for management as well as changes in management strategies remain the same irrespective of the proposed etiology. This chapter provides the specific clinical syndromes that evolve, elucidating how and when treatment decisions to move toward surgery should be made.