Ref (type)	Population	Outcome, Interventions	Results and statistical analysis	Effect size	Favours
Pain relief
RCT	39 patients with pancreatic duct obstruction associated with chronic pancreatitis and severe recurrent pancreatic pain, 54% alcohol-induced, mean age 49 years, 67% male	Mean Izbicki scores 2 years 51 with endoscopic treatment 25 with surgical treatment	Mean difference 24 95% CI 11 to 36 P <0.001	Effect size not calculated	surgical ductal decompression
RCT	39 patients with pancreatic duct obstruction associated with chronic pancreatitis and severe recurrent pancreatic pain, 54% alcohol-induced, mean age 49 years, 67% male	Proportion of people with complete or partial pain relief at 2 years 6/19 (32%) with endoscopy 15/20 (75%) with surgery	P = 0.007	Effect size not calculated	surgical ductal decompression
RCT	72 people with pancreatic duct obstruction associated with chronic pancreatitis, 88% alcohol-induced, mean age 41.7 years, 85% male	People pain-free at 5 years 15% with endoscopic decompression 34% with surgical decompression Absolute numbers not reported	P <0.05	Effect size not calculated	surgical ductal decompression
RCT	72 people with pancreatic duct obstruction associated with chronic pancreatitis, 88% alcohol-induced, mean age 41.7 years, 85% male	People pain-free 1 year and 3 years with endoscopic decompression with surgical decompression Absolute results reported graphically	Significance not assessed
	1018 people with pancreatic duct obstruction associated with chronic pancreatitis, 72% alcohol-induced, mean age 50 years, 71% male	Proportion who had no pain or weak pain at mean 4.9 years 87% (of 758 people) with endoscopic treatment only 79% (of 238 people) with surgical intervention after failed endoscopic treatment Absolute numbers not reported	Significance not assessed