Evaluation of the Quality of Life after Surgical Treatment of Chronic Pancreatitis
Abstract
Objective Pain is the main symptom of chronic pancreatitis. However, in addition to an improvement in pain symptoms, an increase in the quality of life also influences therapeutic success. The present paper evaluates the influence of surgery on chronic pancreatitis, and the early and late postoperative quality of life. Patients From March 2000 until April 2005, 51 patients underwent surgical treatment for chronic pancreatitis at our institution. Intervention Thirty-nine (76.5%) patients were operated on according to the Frey procedure and, in 12 (23.5%) patients, a Whipple procedure was performed. Study design Patient data were documented throughout the duration of the hospital stay. Postoperative follow-up data were recorded retrospectively. Main outcome measures Postoperative follow-up with postoperative pain scores and quality of life were carried out using a standardized questionnaire. Results During a median follow-up period of 50 months, an improvement in pain scores was observed in 92.3% of the patients in the Frey group and in 66.7% in the Whipple group. The indices for global quality of life and for physical and emotional status increased in both surgical groups. Conclusion For patients with chronic pancreatitis, the decisive factor is the quality of life, particularly concerning pain and metabolic changes. The Frey procedure seems to offer advantages with respect to long-term freedom of pain and low risk of surgery-induced pancreatic insufficiency.
Image: University of Schleswig-Holstein. Lübeck, Germany.
Downloads
References
Izbicki JR, Bloechle C, Knoefel WT, Kuechler T, Binmoeller KF, Soehendra N, Broelsch CE. Drainage versus resection in surgical therapy of chronic pancreatitis of the head of the pancreas: a randomized study. Chirurg 1997; 68:369- 377
Bloechle C, Izbicki JR, Knoefel WT, Kuechler T, Broelsch CE. Quality of Life in Chronic Pancreatitis - Results After Duodenum-Preserving Resection of the Head of the Pancreas. Panceas 1995; 11:77-85
Izbicki JR, Bloechle C. Drainage operation as therapeutic principle of surgical organ saving treatmant of chronic pancreatitis. Chirurg 1997; 68:865-873
Frey CF, Pitt HA, Prinz RA. A Plea for Uniform Reporting of Patient Outcome in Chronic Pancreatitis. Arch Surg 1996; 131:233-234
Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, de Haes JC, et al. The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 1993; 85:365-376
Lankisch PG, Löhr-Pappe A, Otto J, Creutzfeldt W. Natural Course in Chronic Pancreatitis. Digestion 1993; 54:148-155
Beger HG, Schoenberg MH, KH Link, Safi F, Berger D. Duodenum-preserving pancreatic head resection: a standard method in chronic pancreatitis. Chirurg 1997; 68:874-880
Lankisch PG. Chronic Pancreatitis -still a surgical disease? Chirurg 1997; 68:851-854
Frey CF, Amikura K. Local resection of the head of the pancreas combined with longitudinal pancreaticojejunostomy in the management of patients with chronic pancreatitis. Ann Surg 1994; 220:492-507.
Izbicki JR, Bloechle C, Knoefel WT, Kuechler T, Binmoeller KF, Broelsch CE. Duodenum-preserving resection of the head of the pancreas in chronic pancreatitis. A prospective, randomized trial. Ann Surg 1995; 221:350-8.
Izbicki JR, Bloechle C, Broering DC, Knoefel WT, Kuechler T, Broelsch CE. Extended drainage versus resection in surgery for chronic pancreatitis. Ann Surg 1998; 228:771-9.
Klempa I, Spatny M, Menzel J, Baca I, Nustede R, Stöckmann F, Arnold W. Pancreatic function and quality of life after resection of the head of the pancreas in chronic pancreatitis. Chirurg 1995; 66:350-359
Witzigmann H, Max D, Uhlmann D, Geissler F, Ludwig S, Schwarz R, Krauss O, et al. Quality of life in chronic pancreatitis: A prospective trial comparing classical whipple procedure and duodenum-preserving pancreatic head resection. J Gastrointest Surg 2002; 6:173-180
Kahl S, Zimmermann S, Leodolter A, Glasbrenner B, Schulz HU, Johnson CD, Malfertheiner P. Quality of Life in Patients with Chronic Pancreatitis after Medical Treatment. Pancreatology 2001; 1:129- 199
Ho HS, Frey CF. Current approach to the surgical management of chronic pancreatitis. Gastroenterologist 1997; 5:128-136
Harrison JL, Prinz RA. The surgical management of chronic pancreatitis: pancreatic duct drainage. Adv Surg 1999; 32:1-21.
Copyright (c) 2011 Philipp Hildebrand, Stefanie Duderstadt, Thomas Jungbluth, Uwe Johannes Roblick, Hans-Peter Bruch, Ralf Czymek
This work is licensed under a Creative Commons Attribution 4.0 International License.
As a member of Publisher International Linking Association, PILA, iMedPub Group’s JOP follows the Creative Commons Attribution License and Scholars Open Access publishing policies. Journal of the Pancreas is the Council Contributor Member of Council of Science Editors (CSE) and following the CSE slogan Education, Ethics, and Evidence for Editors.