Chronic pancreatitis (CP), a disease that

develops as a result of repeated episodes of pancreatic

inflammation and associated fibrosis, restricting functional exocrine

and endocrine pancreatic function and causing severe upper abdominal

pain. Treatment strategies include conservative therapy, consisting

of a step-up approach with pharmacological and lifestyle

modifications. For more advanced cases, endoscopic or surgical

interventions are proposed. However, the exact role and qualification

criteria for surgical management have not been established yet. In

this cohort study, we analysed the results of surgical interventions

in 388 patients with CP performed in the years 2004–2024 in our

centre, including drainage procedures and resections. We assessed the

overall results of the intervention, the possible complications

(assessed by Clavien-Dindo classification), and the risk of

occurrence. Also, the surgery results and the complication risk

between the groups of patients who underwent respective procedures

were compared. The findings indicate that surgery remains an

important tool in CP management, and organ-preserving procedures may

be successful in pain control and overall quality of life

improvement. It is emphasised that personalised surgical strategies

should be the basis of CP management, and the therapy choice must be

established by an experienced multidisciplinary team consisting of

gastroenterologists, endoscopists, radiologists, and surgeons.