Quality of life and functional long-term outcome after partial pancreatoduodenectomy: pancreatogastrostomy versus pancreatojejunostomy.
BACKGROUND
To determine the effects of pancreatogastrostomy (PG) versus pancreatojejunostomy (PJ) as types of reconstruction after partial pancreatoduodenectomy on postoperative quality of life and long-term gastrointestinal morbidity, the outcomes of 104 patients (PG, n = 63; PJ, n = 41) were evaluated.


METHODS
To compare the two groups, the European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire (QLQ-PAN 26) standard and an additional self-developed questionnaire were used. The mean time after surgery was 6.4 +/- 3.4 years.


RESULTS
In the PG group, there was a significant reduction of gastric acid reflux, gastroduodenal ulcers, and pain compared with before surgery. However, a significant increase in steatorrhea, intolerance toward larger meals, and aversion against certain foods were observed. In the PJ group, no significant change of preoperative symptoms was present except for jaundice. The incidence of diabetes mellitus and the need for pancreatic enzyme substitution had increased significantly but similarly in both groups. The global quality of life was identical in both groups of patients.


CONCLUSIONS
This analysis demonstrates that the global quality of life was not affected by the type of reconstruction after partial pancreatoduodenectomy. Patients who underwent PG had a significant reduction of gastric reflux, pain, and abdominal discomfort compared with before surgery. Patients in both groups showed an impaired exocrine and endocrine pancreatic function of a similar extent.
Schmidt
Ursula
U
Klinik für Viszeral und Transplantationschirurgie, Medizinische Hochschule Hannover, Carl-Neuberg-Strasse 1, D-30625 Hannover, Germany. ullaschmidt@aol.com
Simunec
Denis
D
Piso
Pompiliu
P
Klempnauer
Jürgen
J
Schlitt
Hans J
HJ
D015746:Abdominal Pain; D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005764:Gastroesophageal Reflux; D005770:Gastrointestinal Neoplasms / Q000601:surgery*; D005774:Gastrostomy / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000502:physiology* / Q000601:surgery*; D010193:Pancreaticojejunostomy / Q000009:adverse effects; D011788:Quality of Life; D019651:Plastic Surgery Procedures; D016896:Treatment Outcome