title: Impact on quality of life after pancreatoduodenectomy: a prospective study comparing preoperative and postoperative scores.
abstract: BACKGROUND
  Few studies compare the direct impact of pancreatoduodenectomy (PD) on the patient's quality of life (QOL). The effect of PD in QOL, comparing the preoperative vs. postoperative status, was analyzed.
  
  
  METHODS
  A prospective single-center study was performed. PD patients in a 2-year period were included. A general QOL instrument was applied preoperative, 1, 3, 6, and 12 months after surgery and compared with national norms.
  
  
  RESULTS
  Thirty-seven patients were recruited. Twenty of 37 were female. Ampullary carcinoma 14/37, ductal adenocarcinoma in 9/37, and other malignant neoplasms 14/37 were diagnosed. Mortality was absent; 48.6% had complications, 13.5 % required reoperation. Three (median) and 4 (mode) questionnaires were answered per individual. 85 % answered the last questionnaire. 4/37 had cancer related death before a year. Median follow-up was 29 (3-72) months. QOL diminished a month after surgery, physical function (67 vs 40, p<0.0001) and emotional role (37 vs 17, p<0.032) did so significantly. Three months after surgery QOL improved yet not significantly. Six and 12 months postoperatively, physical role (9 vs 49, p=0.001), physical pain (51 vs 71, p=0.01), social function (52 vs 63, p=0.014), vitality (54 vs 64, p=0.018), and emotional role (41 vs 69, p=0.006) improved significantly.
  
  
  CONCLUSIONS
  PD has a favorable impact in quality of life as demonstrated by the improvement of most parameters assessed in the postoperative period.
authors.affiliation: Department of Surgery, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Vasco de Quiroga 15 Col. Sección XVI, Tlalpan, 14000, Mexico, D.F. carchan@prodigy.net.mx
authors.forename: Carlos
authors.initials: C
authors.lastname: Chan
authors.forename: Bernardo
authors.initials: B
authors.lastname: Franssen
authors.forename: Ismael
authors.initials: I
authors.lastname: Domínguez
authors.forename: Alejandro
authors.initials: A
authors.lastname: Ramírez-Del Val
authors.forename: Luis F
authors.initials: LF
authors.lastname: Uscanga
authors.forename: Manuel
authors.initials: M
authors.lastname: Campuzano
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000523:psychology / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D001650:Bile Duct Neoplasms / Q000401:mortality / Q000523:psychology / Q000601:surgery*; D004379:Duodenal Neoplasms / Q000401:mortality / Q000523:psychology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006305:Health Status Indicators; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000523:psychology / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000523:psychology; D011183:Postoperative Complications / Q000453:epidemiology; D011184:Postoperative Period; D057234:Preoperative Period; D011446:Prospective Studies; D011788:Quality of Life; D012086:Reoperation / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult