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Langenbeck's Archives of Surgery

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01-04-2013 | Original Article

Early and late postoperative changes in the quality of life after pancreatic surgery

Authors: Orlin Belyaev, Torsten Herzog, Ansgar M. Chromik, Kirsten Meurer, Waldemar Uhl

Published in: Langenbeck's Archives of Surgery | Issue 4/2013

Abstract

Purpose

To compare health-related quality of life (QoL) before and after surgery for pancreatic disease.

Methods

A retrospective analysis of prospectively gathered data is presented. A total of 174 patients of 230 planned for pancreatic surgery between March and December 2009 at a German high-volume center completed the Short Form-36 (SF-36) Health Survey preoperatively, 133 of them at 3 months and 83 at 24 months after surgery. Data was analysed according to diagnosis and procedure, and compared to German population norms.

Results

QoL in the study group was worse than that of age-matched healthy population at all time points. It decreased continuously in the cancer group, decreased early and showed a trend toward recovery late in patients with benign tumors and chronic pancreatitis. Distal pancreatectomy was the best tolerated and total pancreatectomy the worst tolerated procedure. Older age and development of pancreatic insufficiency affected negatively QoL.

Conclusions

In patients with pancreatic disease, diagnosis determined QoL preoperatively and late after surgery, while in the early postoperative period, type and extent of surgery was the leading factor. Total pancreatectomy had a profound negative effect on QoL and should be reserved for carefully selected patients only.

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Belyaev O, Herzog T, Chromik A, Müller C, Uhl W (2006) Surgery of the pancreas: the surgeon as the crucial prognostic factor (in German with English abstract). Gastroenterologe 1:34–42CrossRef

Pezzilli R, Fantini L, Morselli-Labate AM (2007) Pancreatectomy for pancreatic disease and quality of life. JOP 8(1 Suppl):118–131PubMed

Warnick SJ Jr, Velanovich V (2006) Correlation of patient-derived utility values and quality of life after pancreaticoduodenectomy for pancreatic cancer. J Am Coll Surg 202:906–911PubMedCrossRef

Ljungman D, Lundholm K, Hyltander A (2011) Cost-utility estimation of surgical treatment of pancreatic carcinoma aimed at cure. World J Surg 35:662–670PubMedCrossRef

Velanovich V (2011) The association of quality-of-life measures with malignancy and survival in patients with pancreatic pathology. Pancreas 40:1063–1069PubMedCrossRef

Yeo TP, Burrell SA, Sauter PK, Kennedy EP, Lavu H, Leiby BE et al (2012) A progressive postresection walking program significantly improves fatigue and health-related quality of life in pancreas and periampullary cancer patients. J Am Coll Surg 214:463–475PubMedCrossRef

Chan C, Franssen B, Domínguez I, Ramírez-Del Val A, Uscanga LF, Campuzano M (2012) Impact on quality of life after pancreatoduodenectomy: a prospective study comparing preoperative and postoperative scores. J Gastrointest Surg 16:1341–1346PubMedCrossRef

Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6,336 patients and results of a survey. Ann Surg 240:205–213PubMedCrossRef

Bassi C, Dervenis C, Butturini G, Fingerhut A, Yeo C, Izbicki J et al (2005) Postoperative pancreatic fistula: an international study group (ISGPF) definition. Surgery 138:8–13PubMedCrossRef

10.

Morfeld M, Bullinger M, Nantke J, Brähler E (2005) The version 2.0 of the SF-36 Health Survey: results of a population-representative study. (Article in German). Soz Praventivmed 50:292–300PubMedCrossRef

11.

Ware J, Sherbourne C (1992) The MOS 36-item short-form health survey (SF-36). Conceptual framework and item selection. Med Care 30:473–483PubMedCrossRef

12.

Halloran CM, Cox TF, Chauhan S, Raraty MG, Sutton R, Neoptolemos JP et al (2011) Partial pancreatic resection for pancreatic malignancy is associated with sustained pancreatic exocrine failure and reduced quality of life: a prospective study. Pancreatology 11:535–545PubMedCrossRef

13.

Billings BJ, Christein JD, Harmsen WS, Harrington JR, Chari ST, Que FG et al (2005) Quality-of-life after total pancreatectomy: is it really that bad on long-term follow-up? J Gastrointest Surg 9:1059–1066PubMedCrossRef

14.

Morgan K, Owczarski SM, Borckardt J, Madan A, Nishimura M, Adams DB (2012) Pain control and quality of life after pancreatectomy with islet autotransplantation for chronic pancreatitis. J Gastrointest Surg 16:129–33PubMedCrossRef

15.

Sutherland DE, Radosevich DM, Bellin MD, Hering BJ, Beilman GJ, Dunn TB et al (2012) Total pancreatectomy and islet autotransplantation for chronic pancreatitis. J Am Coll Surg 214:409–424PubMedCrossRef

16.

Mbah N, Brown RE, St Hill CR, Bower MR, Ellis SF, Scoggins CR et al (2012) Impact of post-operative complications on quality of life after pancreatectomy. JOP 13:387–393PubMed

17.

Scheingraber S, Scheingraber T, Brauckhoff M, Dralle H (2005) Comparison between a general and a disease-specific health-related quality-of-life questionnaire in patients after pancreatic surgery. J Hepatobiliary Pancreat Surg 12:290–297PubMedCrossRef

18.

Pezzilli R, Falconi M, Zerbi A, Casadei R, Valli L, Varale R et al (2011) Clinical and patient-reported outcomes after pancreatoduodenectomy for different diseases: a follow-up study. Pancreas 40:938–945PubMedCrossRef

19.

Cahen DL, Gouma DJ, Nio Y, Rauws EA, Boermeester MA, Busch OR et al (2007) Endoscopic versus surgical drainage of the pancreatic duct in chronic pancreatitis. N Engl J Med 356:676–684PubMedCrossRef

20.

Cahen DL, Gouma DJ, Laramée P, Nio Y, Rauws EA, Boermeester MA et al (2011) Long-term outcomes of endoscopic vs surgical drainage of the pancreatic duct in patients with chronic pancreatitis. Gastroenterology 141:1690–1695PubMedCrossRef

21.

Prochorov AV, Oldhafer KJ, Tretyak SI, Rashchynski SM, Donati M, Rashchynskaya NT et al (2012) Surgical treatment of pain in patients with chronic pancreatitis. Hepatogastroenterology 59:1265–1269PubMed

22.

Hildebrand P, Duderstadt S, Jungbluth T, Roblick UJ, Bruch HP, Czymek R (2011) Evaluation of the quality of life after surgical treatment of chronic pancreatitis. JOP 12:364–371PubMed

23.

Schnelldorfer T, Lewin DN, Adams DB (2007) Operative management of chronic pancreatitis: long-term results in 372 patients. J Am Coll Surg 204:1039–1045PubMedCrossRef

24.

van Loo ES, van Baal MC, Gooszen HG, Ploeg RJ, Nieuwenhuijs VB (2010) Long-term quality of life after surgery for chronic pancreatitis. Br J Surg 97:1079–1086PubMedCrossRef

Title: Early and late postoperative changes in the quality of life after pancreatic surgery
Authors: Orlin Belyaev
Torsten Herzog
Ansgar M. Chromik
Kirsten Meurer
Waldemar Uhl
Publication date: 01-04-2013
Publisher: Springer-Verlag
Published in: Langenbeck's Archives of Surgery / Issue 4/2013
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-013-1076-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Early and late postoperative changes in the quality of life after pancreatic surgery

Abstract

Purpose

Methods

Results

Conclusions

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Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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