Comparison of quality of life after pylorus-preserving pancreatoduodenectomy and Whipple resection.
OBJECTIVE
There have been many supportive data that the postoperative changes in nutritional status are more favorable after pylorus-preserving pancreatoduodenectomy than after Whipple resection; however, few reports are available on the postoperative changes in subjective quality of life after pancreatoduodenectomy. The aim of this study was to compare the postoperative change in quality of life after pylorus-preserving pancreatoduodenectomy and Whipple resection.


METHODS
A total of 36 patients (31 with pylorus-preserving pancreatoduodenectomy and five with Whipple resection) were studied regarding quality of life before and at short term (within two months) and at long term (six months to one year) after surgery, using a questionnaire. The questionnaire consisted of 13 physical and 10 psychosocial items. The medical records were also reviewed to evaluate their objective nutritional status. Postoperative changes in quality of life and nutritional status were compared between the pylorus-preserving pancreatoduodenectomy and Whipple groups.


RESULTS
Overall and physical quality of life scores dropped at short term and then recovered at long term in the pylorus-preserving pancreatoduodenectomy group, but showed a persistently low value even at long term in the Whipple group. The change in physical quality of life showed almost parallel changes with the nutritional status in both groups. However, the scores of psychosocial quality of life, which reflected the patient's mental status, remained low even at long term in both pylorus-preserving pancreatoduodenectomy and Whipple groups.


CONCLUSIONS
Quality of life is more favorable after pylorus-preserving pancreatoduodenectomy than after Whipple resection, but long-standing mental health care is necessary in patients with pyloruspreserving pancreatoduodenectomy and Whipple resection.
Ohtsuka
Takao
T
Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan.
Yamaguchi
Koji
K
Ohuchida
Jiro
J
Inoue
Ken
K
Nagai
Eishi
E
Chijiiwa
Kazuo
K
Tanaka
Masao
M
D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014670:Ampulla of Vater / Q000601:surgery*; D001651:Cholestasis, Extrahepatic / Q000601:surgery*; D003138:Common Bile Duct Neoplasms / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D016577:Pancreaticoduodenectomy / Q000379:methods*; D011183:Postoperative Complications / Q000523:psychology*; D011706:Pyloric Antrum / Q000601:surgery*; D011788:Quality of Life / Q000523:psychology*; D012803:Sick Role; D018434:Sickness Impact Profile