The comparison of resection and duodenum sparing surgery in patients suffering from painful chronic pancreatitis - Prospective study
Abstract
Aim of this study is the comparison of two surgical procedures in the treatment of chronic pancreatitis (CP), pancreatoduodenectomy resection (classical Whipple - PD and pylorus preserving - PPPD) with duodenum-preserving pancreatic head excision and longitudional pancreatojejunoanastomosis (DPPHE) to define the advantages of each procedure with regard to postoperative complications, pain relief, and the quality of life. One hundred and four consecutive patients were included into this study.
Duodenopancreatectomy was chosen when the pancreatic head enlargement was present or pancreatic cancer could not be ruled out (48 patients); otherwise DPPHE was performed (56 patients). Quality of life was measured prospectively on two occasions, before the procedure and during follow-up (median 39 months after surgery) using the European Organization for Research and Treatment of Cancer (EORTC) Quality-of-Life Questionnaire (QLQ-C30).
Total pain score decreased significantly after surgery in both groups of patients. During the follow-up period, the global quality of life improved to 30.4 % in the DPPHE/PJA group, and to 23.2 % in the PD/PPPD group.
Postoperative morbidity and mortality were higher in the resection group, but the differences were not significant. Both surgical procedures led to significant improvement of the quality of life and pain relief after surgery for CP.
The EORTC QLQ-C30 was found to be a valid and readily available test for quality-of-life assessment in patients with chronic pancreatitis.