Department of Biliary-Pancreatic Surgery, Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China.
World J Gastroenterol. 2024 Feb 28;30(8):943-955. doi: 10.3748/wjg.v30.i8.943.
Pancreatic surgery is challenging owing to the anatomical characteristics of the pancreas. Increasing attention has been paid to changes in quality of life (QOL) after pancreatic surgery.
To summarize and analyze current research results on QOL after pancreatic surgery.
A systematic search of the literature available on PubMed and EMBASE was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Relevant studies were identified by screening the references of retrieved articles. Studies on patients' QOL after pancreatic surgery published after January 1, 2012, were included. These included prospective and retrospective studies on patients' QOL after several types of pancreatic surgeries. The results of these primary studies were summarized inductively.
A total of 45 articles were included in the study, of which 13 were related to pancreaticoduodenectomy (PD), seven to duodenum-preserving pancreatic head resection (DPPHR), nine to distal pancreatectomy (DP), two to central pancreatectomy (CP), and 14 to total pancreatectomy (TP). Some studies showed that 3-6 months were needed for QOL recovery after PD, whereas others showed that 6-12 months was more accurate. Although TP and PD had similar influences on QOL, patients needed longer to recover to preoperative or baseline levels after TP. The QOL was better after DPPHR than PD. However, the superiority of the QOL between patients who underwent CP and PD remains controversial. The decrease in exocrine and endocrine functions postoperatively was the main factor affecting the QOL. Minimally invasive surgery could improve patients' QOL in the early stages after PD and DP; however, the long-term effect remains unclear.
The procedure among PD, DP, CP, and TP with a superior postoperative QOL is controversial. The long-term benefits of minimally invasive versus open surgeries remain unclear. Further prospective trials are warranted.
胰腺手术具有挑战性，这是由于胰腺的解剖学特点所致。人们越来越关注胰腺手术后生活质量（QOL）的变化。
总结和分析胰腺手术后 QOL 的现有研究结果。
根据系统评价和荟萃分析的首选报告项目指南，在 PubMed 和 EMBASE 上进行了文献系统搜索。通过筛选检索到的文章的参考文献来确定相关研究。纳入了 2012 年 1 月 1 日以后发表的关于胰腺手术后患者 QOL 的研究。这些研究包括了多种胰腺手术后患者 QOL 的前瞻性和回顾性研究。这些初步研究的结果是通过归纳总结的。
共纳入 45 篇文章，其中 13 篇与胰十二指肠切除术（PD）相关，7 篇与保留十二指肠胰头切除术（DPPHR）相关，9 篇与胰体尾切除术（DP）相关，2 篇与胰中段切除术（CP）相关，14 篇与全胰切除术（TP）相关。一些研究表明，PD 后需要 3-6 个月才能恢复 QOL，而其他研究则表明 6-12 个月更为准确。虽然 TP 和 PD 对 QOL 有相似的影响，但 TP 患者需要更长的时间才能恢复到术前或基线水平。DPPHR 后 QOL 优于 PD。然而，CP 和 PD 患者之间的 QOL 优势仍存在争议。术后外分泌和内分泌功能的下降是影响 QOL 的主要因素。PD 和 DP 术后微创可改善患者早期 QOL，但长期效果尚不清楚。
PD、DP、CP 和 TP 中哪种术式术后 QOL 更优存在争议。微创与开放手术的长期获益仍不清楚。需要进一步的前瞻性试验。
