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Patient reported outcomes of duodenum-preserving pancreatic head resection in chronic pancreatitis: high effectivity is impaired by prolonged non-surgical management

Background: Chronic pancreatitis (CP) causes suffering and socioeconomic burden. This study evaluated perioperative results and patient-reported outcomes (PRO) in CP patients treated with duodenumpreserving pancreatic head resection (DPPHR).Methods: Data were analyzed of CP patients undergoing DPPHR...

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Main Authors: Leonhardt, Carl-Stephan (Author) , Niesen, Willem (Author) , Pils, Dietmar (Author) , Angelova, Yoana (Author) , Hankeln, Thomas (Author) , Scheele, Christian (Author) , Hinz, Ulf (Author) , Hackert, Thilo (Author) , Büchler, Markus W. (Author) , Strobel, Oliver (Author)
Format: Article (Journal)
Language:English
Published: January 2024
In: HPB
Year: 2024, Volume: 26, Issue: 1, Pages: 73-82
ISSN:1477-2574
DOI:10.1016/j.hpb.2023.10.002
Online Access:Verlag, Volltext: https://doi.org/10.1016/j.hpb.2023.10.002
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Author Notes:Carl-Stephan Leonhardt, Willem Niesen, Dietmar Pils, Yoana Angelova, Thomas Hank, Christian Scheele, Ulf Hinz, Thilo Hackert, Markus W. Buechler, Oliver Strobel
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Summary:Background: Chronic pancreatitis (CP) causes suffering and socioeconomic burden. This study evaluated perioperative results and patient-reported outcomes (PRO) in CP patients treated with duodenumpreserving pancreatic head resection (DPPHR).Methods: Data were analyzed of CP patients undergoing DPPHR between 01/2001-10/2014. PROs were measured using a specifically designed questionnaire and the EORTC QLQ-C30/PAN26. Associations between treatment variables and PROs were examined.Results: Of 332 patients who received DPPHR, most (n = 251, 75.6%) underwent the Berne modification. Surgical morbidity was 21.5% (n = 71) and 90-day mortality 1.5% (n = 5). Median follow-up was 79.9 months, 5-year survival 90.5%, and 1.8% of patients developed pancreatic cancer. Of 283 patients alive, 178 (62.9%) returned questionnaires. Referral for surgery was self-initiated (38.0% of cases), by gastroenterologists (27.5%) and by general practitioners (21.1%). QoL improved in 78.7% of patients, remained stable in 12.1%, and worsened in 9.1%. Median Izbicki scores decreased from 90 to 5 points after surgery (p < 0.0001). Time from diagnosis to DPPHR was an independent, proportional predictor of a higher postoperative Izbicki score (p = 0.04).Conclusion: DPPHR is an effective, safe treatment for CP. A delay in surgery decreases surgical effectivity, hence CP patients should be referred to surgery early to ensure satisfactory outcomes.
Item Description:Gesehen am 12.08.2024
Physical Description:Online Resource
ISSN:1477-2574
DOI:10.1016/j.hpb.2023.10.002

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