Huang J J, Yeo C J, Sohn T A, Lillemoe K D, Sauter P K, Coleman J, Hruban R H, Cameron J L
Departments of Surgery, Oncology, and Pathology, The Johns Hopkins Medical Institutions, Baltimore, Maryland 21287-4606, USA.
Ann Surg. 2000 Jun;231(6):890-8. doi: 10.1097/00000658-200006000-00014.
To assess the quality of life (QOL) and functional outcome of patients after pancreaticoduodenectomy.
Pancreaticoduodenectomy is gaining acceptance and is being performed in increasing numbers for various malignant and benign diseases of the pancreas and periampullary region. There is a general impression that pancreaticoduodenectomy can severely impair QOL and alter normal activities. Only a few small studies have evaluated QOL after pancreaticoduodenectomy.
A standard QOL questionnaire was sent to 323 patients surviving pancreaticoduodenectomy who had undergone surgery at The Johns Hopkins Hospital between 1981 and 1997. Thirty items on a visual analog scale were categorized 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 laparoscopic cholecystectomy patients and healthy controls. A separate component of the questionnaire asked about functional outcomes and disabilities.
Overall QOL scores for the 192 responding pancreaticoduodenectomy patients 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 pancreaticoduodenectomy patients were subgrouped into chronic pancreatitis, other benign disease, pancreatic adenocarcinoma, and other cancers. Patients who underwent resection for chronic pancreatitis and pancreatic adenocarcinoma had significantly lower QOL scores in the physical and psychological domains compared with the laparoscopic cholecystectomy patients and the healthy controls. Common problems after pancreaticoduodenectomy were weight loss, abdominal pain, fatigue, foul stools, and diabetes.
This is the largest single-institution experience assessing QOL after pancreaticoduodenectomy. These data demonstrate that as a group, patients who survive pancreaticoduodenectomy have near-normal QOL scores. Many patients report weight loss and symptoms consistent with pancreatic exocrine and endocrine insufficiency. Most patients have QOL scores comparable to those of control patients and can function independently in daily activities.
评估胰十二指肠切除术后患者的生活质量（QOL）和功能结局。
胰十二指肠切除术正逐渐被接受，并且因胰腺及壶腹周围区域的各种恶性和良性疾病而实施的例数在不断增加。人们普遍认为胰十二指肠切除术会严重损害生活质量并改变正常活动。仅有少数小型研究评估了胰十二指肠切除术后的生活质量。
向323例在1981年至1997年间于约翰霍普金斯医院接受胰十二指肠切除术且存活的患者发送了一份标准生活质量问卷。视觉模拟量表上的30个项目被分为三个领域：身体（15项）、心理（10项）和社会（5项）。得分以百分位数报告，100%为可能的最高分。同样的生活质量问卷也发送给了腹腔镜胆囊切除术患者和健康对照者。问卷的一个单独部分询问了功能结局和残疾情况。
192例回复的胰十二指肠切除术患者在三个领域（身体、心理、社会）的总体生活质量得分分别为78%、79%和81%。这些生活质量得分与37例腹腔镜胆囊切除术患者和31例健康对照者的得分相当。胰十二指肠切除术患者被分为慢性胰腺炎、其他良性疾病、胰腺腺癌和其他癌症亚组。与腹腔镜胆囊切除术患者和健康对照者相比，因慢性胰腺炎和胰腺腺癌接受切除术的患者在身体和心理领域的生活质量得分显著更低。胰十二指肠切除术后的常见问题包括体重减轻、腹痛、疲劳、大便恶臭和糖尿病。
这是评估胰十二指肠切除术后生活质量的最大规模单机构经验。这些数据表明，作为一个群体，胰十二指肠切除术后存活的患者生活质量得分接近正常。许多患者报告有体重减轻以及与胰腺外分泌和内分泌功能不全相符的症状。大多数患者的生活质量得分与对照患者相当，并且能够在日常活动中独立生活。
