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Quality of Life Following Major Laparoscopic or Open Pancreatic Resection

  • Pancreatic Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Purpose

This study was designed to compare quality of life (QoL) among patients who underwent open versus laparoscopic pancreatic resection, including distal pancreatectomy and pancreaticoduodenectomy, and to identify clinical characteristics that are associated with changes in QoL.

Methods

Quality of life (QoL) was assessed in patients undergoing pancreatic resection with the Functional Assessment of Cancer Therapy-Hepatobiliary questionnaire preoperatively and 2 weeks, 1, 3, and 6 months postoperatively. Multilevel regression modeling was used to determine the variability in each QoL domain within the first 2 weeks (postoperative period) and thereafter (recovery period).

Results

Among 159 patients, 60.4% underwent open and 39.6% underwent laparoscopic surgery. Physical, functional, hepatobiliary, and total QoL scores decreased in the postoperative period but returned to baseline levels by 6 months postoperatively. Emotional QoL improved from baseline by 2 weeks after surgery (p < 0.001) and social QoL improved from baseline by 3 months after surgery (p < 0.001). Emotional QoL was the only domain where significant differences were observed in QoL in the postoperative and recovery periods between patients who underwent open and laparoscopic pancreatic resection. Controlling for surgical approach, patients who experienced a grade III or IV complication experienced greater declines in physical, functional, hepatobiliary, and total QoL in the postoperative period. The negative impact of complications on QoL resolved by 6 months postoperatively.

Conclusions

The impact of pancreatic resection on QoL was comparable between patients who underwent laparoscopic versus open pancreatic resection. Complications were strongly associated with changes in postoperative QoL, suggesting that performing a safe operation is the best approach for optimizing patient reported QoL.

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Authors and Affiliations

  1. Department of Surgery, University of Colorado, Aurora, CO, USA

    Robert J. Torphy MD, Brandon C. Chapman MD, Chloe Friedman MPH, Christina Nguyen BS, Christan G. Bartsch MPH PA-C, Cheryl Meguid DNP, Steven A. Ahrendt MD, Martin D. McCarter MD, Marco Del Chiaro MD, Richard D. Schulick MD, MBA & Ana Gleisner MD, PhD

  2. Department of Surgery, University of Oklahoma, Oklahoma City, OK, USA

    Barish H. Edil MD

Authors
  1. Robert J. Torphy MD
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  2. Brandon C. Chapman MD
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  3. Chloe Friedman MPH
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  4. Christina Nguyen BS
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  5. Christan G. Bartsch MPH PA-C
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  6. Cheryl Meguid DNP
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  7. Steven A. Ahrendt MD
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  8. Martin D. McCarter MD
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  9. Marco Del Chiaro MD
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  10. Richard D. Schulick MD, MBA
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  11. Barish H. Edil MD
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  12. Ana Gleisner MD, PhD
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Corresponding author

Correspondence to Ana Gleisner MD, PhD.

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The authors declare no conflicts of interest.

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Supplemental Fig.

 1 Study population flow diagram (PDF 7 kb)

Supplemental Fig.

 2 Boxplots of FACT-Hep subscale (A-E) and total (F) QoL scores from preop to 6 months following pancreatic resection. In the box plots, the boundary of the box closest to 0 represents the 25th percentile, the line in the box represents the median, and the boundary of the box farthest from 0 represents the 75th percentile. The whiskers represent scores less than 1.5× interquartile range, and the points below the whiskers indicate outliers that are lower than 1.5× interquartile range (TIFF 76733 kb)

Supplemental Fig.

 3 Mean trajectories of FACT-Hep subscale and Total QoL scores at 2 weeks, 1 month, 3 months, and 6 months postoperatively by operation and surgical approach (TIFF 76735 kb)

Supplementary material 4 (DOCX 20 kb)

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Torphy, R.J., Chapman, B.C., Friedman, C. et al. Quality of Life Following Major Laparoscopic or Open Pancreatic Resection. Ann Surg Oncol 26, 2985–2993 (2019). https://doi.org/10.1245/s10434-019-07449-x

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  • DOI: https://doi.org/10.1245/s10434-019-07449-x

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