McLeod R S, Taylor B R, O'Connor B I, Greenberg G R, Jeejeebhoy K N, Royall D, Langer B
Department of Surgery, University of Toronto, Ontario, Canada.
Am J Surg. 1995 Jan;169(1):179-85. doi: 10.1016/s0002-9610(99)80129-9.
To compare the quality of life, nutritional status, and gastrointestinal profiles of post-Whipple patients and postcholecystectomy patients.
A cross-sectional survey of post-Whipple procedure patients and age- and sex-matched postcholecystectomy patients was performed. Quality of life was assessed using six instruments: Time Trade-off Technique, Direct Questioning of Objectives, Gastrointestinal Quality of Life Index, Sickness Impact Profile, Physician Global Assessment, and Visick Scale. A gastrointestinal symptomatology questionnaire was completed. Nutritional status was assessed by weight, the Subjective Global Assessment instrument, and skin anthropometry. Fasting and postprandial serum gastrin, somatostatin, insulin, pancreatic glucagon, enteroglucagon, and pancreatic polypeptide were measured.
The quality of life and gastrointestinal function of the Whipple patients was excellent and was not significantly different from that of the control subjects. There were no significant differences in gastrointestinal symptomatology although 5 Whipple patients complained of greasy bowel movements, and 1 patient reported difficulty maintaining weight. Despite this, nutritional status was within normal limits in all subjects. Six patients in the Whipple group followed a diabetic diet, 1 required insulin, and 3 required an oral hypoglycemic agent, whereas none of the control subjects were diabetic. There were no significant differences in the mean basal, peak, or integrated postprandial responses of the gut hormones with the exception of pancreatic polypeptide and gastrin (in patients having a standard Whipple procedure only).
Quality of life and nutritional status are excellent in patients following a Whipple procedure.
比较惠普尔手术患者与胆囊切除术后患者的生活质量、营养状况和胃肠道情况。
对惠普尔手术患者以及年龄和性别匹配的胆囊切除术后患者进行横断面调查。使用六种工具评估生活质量：时间权衡技术、目标直接询问法、胃肠道生活质量指数、疾病影响概况、医生整体评估和维西克量表。完成一份胃肠道症状问卷。通过体重、主观全面评定工具和皮肤人体测量评估营养状况。测量空腹和餐后血清胃泌素、生长抑素、胰岛素、胰高血糖素、肠高血糖素和胰多肽。
惠普尔手术患者的生活质量和胃肠道功能良好，与对照组无显著差异。胃肠道症状方面无显著差异，尽管有5名惠普尔手术患者抱怨大便油腻，1名患者报告体重维持困难。尽管如此，所有受试者的营养状况均在正常范围内。惠普尔组有6名患者遵循糖尿病饮食，1名需要胰岛素，3名需要口服降糖药，而对照组均无糖尿病。除胰多肽和胃泌素（仅在接受标准惠普尔手术的患者中）外，肠道激素的平均基础、峰值或餐后综合反应无显著差异。
惠普尔手术后患者的生活质量和营养状况良好。
