Abstract
Background: Quality of Life (QoL) is widely known to be poor after total pancreatectomy. This study was designed to evaluate the short-term and long-term consequences of endocrine and exocrine insufficiency and their associated effects on QoL and nutritional status. Methods: Prospective data was collected from patients who underwent total pancreatectomy at Seoul National University Hospital during an interval of 4 years and followed up for at least 1 year. QoL, and nutritional status were assessed by administering validated questionnaires (EORTC QLQ C-30, PAN26, GIQLI, MNA), preoperatively and 3, 12 months postoperatively. Results: A total of 30 patients were eligible for the study. 3 months after receiving total pancreatectomy, the global heath score (GHS) showed no significant difference (preoperatively 57.2 vs. 3 months postoperatively 68.3; P=0.119). By the 1st postoperative year, the GHS still showed no significant difference (preoperatively 57 vs. 1 year postoperatively 52.4; P=0.2) and no significant differences in most of the QoL categories. However, poor physical function (79.2 vs. 67.6; P=0.01), digestive difficulties (14.9 vs. 36.9; P=0.03) and altered bowel habits (9.2 vs. 25.6; P=0.03) continued even 1 year after surgery. Conclusion: The overall QoL score after total pancreatectomy was comparable to the preoperative QoL score. Some symptoms after total pancreatectomy significantly worsen after 3 months postoperatively, but then improve to a comparable level 1 year after surgery. Because some symptoms persist even after time has passed, supportive management is needed for total pancreatectomy patients, including nutritional support with pancreatic enzyme replacement and education for diabetes and diet.
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