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10.1245/ASO.2005.04.005
Annals of Surgical Oncology 12:467-472 (2005)
© 2005 Society of Surgical Oncology
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Original Article

Quality of Life and Functional Long-Term Outcome After Partial Pancreatoduodenectomy: Pancreatogastrostomy Versus Pancreatojejunostomy

Ursula Schmidt, MD1, Denis Simunec, MD1, Pompiliu Piso, MD2, Jürgen Klempnauer, MD1 and Hans J. Schlitt, MD2

1 Klinik für Viszeral- und Transplantationschirurgie, Medizinische Hochschule Hannover, Carl-Neuberg-Strasse 1, D-30625, Hannover, Germany
2 Klinik und Poliklinik für Chirurgie, Universität Regensburg, Franz-Josef-Strauss-Allee 11, D-93042 Regensburg, Germany

Correspondence: Address correspondence and reprint requests to: Ursula Schmidt, MD; E-mail: ullaschmidt{at}aol.com

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, gastro-duodenal 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.

Key Words: Quality of life • Partial pancreatoduodenectomy • Pancreatojejunostomy • Pancreatogastrostomy • EORTC QLQ-PAN 26




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C. D. Johnson, F. Howse, D. Fitzsimmons, S. Harris, R. Pickering, and S. L. George
Quality of Life after Pancreatectomy
Ann. Surg. Oncol., February 1, 2007; 14(2): 750 - 751.
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