Objective To assess the quality of life (QOL) and functional outcome of pat
ients after pancreaticoduodenectomy.
Summary Background Data Pancreaticoduodenectomy is gaining acceptance and i
s being performed in increasing numbers for various malignant and benign di
seases of the pancreas and periampullary region. There is a general impress
ion that pancreaticoduodenectomy can severely impair QOL and alter normal a
ctivities. Only a few small studies have evaluated QOL after pancreaticoduo
denectomy.
Methods A standard QOL questionnaire was sent to 323 patients surviving pan
creaticoduodenectomy who had undergone surgery at The Johns Hopkins Hospita
l between 1981 and 1997. Thirty items on a visual analog scale were categor
ized into three domains: physical (15 items), psychological (10 items), and
social (5 items). Scores are reported as a percentile, with 100% being the
highest possible score. The same QOL questionnaire was also sent to laparo
scopic cholecystectomy patients and healthy controls. A separate component
of the questionnaire asked about functional outcomes acid disabilities.
Results Overall QOL scores for the 192 responding pancreaticoduodenectomy p
atients in the three domains (physical, psychological, social) were 78%, 79
%, and 81%, respectively. These QOL scores were comparable to those of the
37 laparoscopic cholecystectomy patients and the 31 healthy controls. The p
ancreaticoduodenectomy patients were subgrouped into chronic pancreatitis,
other benign disease, pancreatic adenocarcinoma, and other cancers. Patient
s who underwent resection for chronic pancreatitis and pancreatic adenocarc
inoma had significantly lower QOL scores in the physical and psychological
domains compared with the laparoscopic cholecystectomy patients and the hea
lthy controls. Common problems after pancreaticoduodenectomy were weight lo
ss, abdominal pain, fatigue, foul stools, and diabetes.
Conclusions This is the largest single-institution experience assessing QOL
after pancreaticoduodenectomy. These data demonstrate that as a group, pat
ients who survive pancreaticoduodenectomy have near-normal QOL scores. Many
patients report weight loss and symptoms consistent with pancreatic exocri
ne and endocrine insufficiency. Most patients have QOL scores comparable to
those of control patients and can function independently in daily activiti
es.