Dear Editor,

We would like to comment on the publication “Surgery for chronic pancreatitis: the comparison of two high-volume centers reveals lack of a uniform operative management? [1].” Surci et al. concluded that a study of two high-volume hospitals’ surgical attitudes toward chronic pancreatitis revealed that a standard approach to this condition is still lacking [1]. Although surgery can be conducted in specialist clinics with outstanding results, Surci et al. cautioned that it should always be carefully examined because it must be tailored to unique clinical settings and individual patients [1]. A question that has arisen is whether a common guideline for case management is required. In general, a practical standard guideline should exist, and there should be little variation. It is difficult to establish a consistent operational management system. It may be necessary to reach a consensus, and the Delphi technique survey may be used. Drewes et al. [2] published a recent paper that is a nice example of such an endeavor. The guideline, however, must be flexible. A special guideline for the treatment of chronic pancreatitis with a specific variety may also be established.