Quality Of Life After Modified Pancreatoduodenectomy For The Preservation Of Ascending Portion Of Duodenum

Background:More and more long-term survivors after modified pancreatoduodenectomy for thepreservation of ascending portion of duodenum(MPPAPD), postoperative quality of life(QOL) has become a great concern. However, few reports are available on data of thepostoperative changes in QOL after MPPAPD.Methods:A total of 20 patients were studied regarding QOL before and at short term (within 2months), intermediate term (6 months), and long term (1 year) after MPPAPD, usinga questionnaire. The questionnaire consisted of 13 physical and 10 psychosocialitems. The medical records were also reviewed to evaluate objectivenutritional status. Factors predicting delayed recovery of QOL wereexamined at intermediate term by univariate and multivariate analyses.Results:Overall and physical QOL scores returned to the preoperative level at intermediate termafter MPPAPD, showing parallel changes with the objective nutritional status. However,the scores of psychosocial condition, which reflected the patient's mental health,remained low even at long term. QOL scores at intermediate term in patients withpancreatic carcinoma were significantly lower than those with other diseases. Univariateanalysis showed that preoperative body weight loss, impaired preoperative pancreaticexocrine function, long operative time, intraoperative chemotherapy, pancreaticcarcinoma, and postoperative diarrhea were factors predicting the delayed recovery ofQOL. Multivariate analysis revealed that preoperative pancreatic exocrine functionsignificantly affected the delayed recovery of QOL.Conclusions:Preoperative supplement of pancreatic enzymes together with perioperative mental care would improve QOL at long term after MPPAPD.