Society for Surgery of the Alimentary Tract

1998 Abstract: QUALITY OF LIFE DURING THE FIRST YEAR AFTER PPPD FOR PERIAMPULLARY CARCINOMA.. E.J.Nieveen van Dijkum1, C.B. Terwee2, J.H.vd Meulen2, H.C. de Haes3, J.J.B. van Lanschot1, D.J. Gouma1. Depts of Surgery, Epidemiology2 and Medical Psychology3, Academic Medical Center, Amsterdam, The Netherlands. 121

Abstracts
1998 Digestive Disease Week

#1025

QUALITY OF LIFE DURING THE FIRST YEAR AFTER PPPD FOR PERIAMPULLARY CARCINOMA.. E.J.Nieveen van Dijkum1, C.B. Terwee2, J.H.vd Meulen2, H.C. de Haes3, J.J.B. van Lanschot1, D.J. Gouma1. Depts of Surgery, Epidemiology2 and Medical Psychology3, Academic Medical Center, Amsterdam, The Netherlands.

A curative pyloruspreserving pancreatoduodenectomy (PPPD) is the only chance for cure in patients with periampullary tumors. Many clinicians are however sceptic about this procedure, not only because it is associated with considerable morbidity, mortality and a 5-year survival rate of only 15-30%, but in particular because a PPPD will decrease the quality of life (QOL) of these patients during their relatively short survival. In this study QOL during the first year after a PPPD is investigated to assess if this scepticism is justified. From September 1995 to January 1996 patients who underwent a radical or irradical PPPD for a periampullary malignancy were asked to participate in a QOL-study. Patients filled in a questionnaire comprising a generic QOL-questionnaire (MOS-24) and a disease-specific QOL-questionnaire (GIQLI) preoperatively and postoperatively at two weeks, 3,6,9 and 12 months after discharge. The MOS-24 was transformed to 7 subscales each with a 0-100 points-scale, the GIQLI is used as total-score ranging from 0-144; higher scores indicate better health for both MOS and GIQLI. Included were 26 patients who underwent a PPPD. Pre-operative QOL decreased as compared to the reference population (Stewart,1991), except for the pain score. At 2 weeks after discharge patients were worse on the physical, pain, role functioning and social subscale. At 3 months after discharge the mean score returned to pre-operative values or better scores and remained stable in all subscales. The GIQLI decreased after PPPD, returned to a better score after 3 months and remained the same until 12 months after discharge.

MeanMOS-24ac	ref.pop	pre-OK	2 w	3 m	6 m	9 m	12 m
energy	-	55	54	68	67	66	57
health perceptions	72*	46	45	60	59	55	48
physical functioning	86*	54	40*	65	64	61	61
bodily pain	74	78	61*	79	74	67	71
mental health	77*	66	71	82	81	76	68
role functioning	87*	29	10*	65	65	56	64
social functioning	92*	69	46*	81	84	74	73
GIQLI	-	104	99	112	114	109	110

*Student t-test, p < 0.05 to pre-OK values

In conclusion QOL returned to preoperative values within 3 months. Therefore the concern about impaired QOL after resection should not interfere with the decision to perform a PPPD.

Abstracts1998 Digestive Disease Week

QUALITY OF LIFE DURING THE FIRST YEAR AFTER PPPD FOR PERIAMPULLARY CARCINOMA.. E.J.Nieveen van Dijkum1, C.B. Terwee2, J.H.vd Meulen2, H.C. de Haes3, J.J.B. van Lanschot1, D.J. Gouma1. Depts of Surgery, Epidemiology2 and Medical Psychology3, Academic Medical Center, Amsterdam, The Netherlands.

Copyright 1996 - 1998, SSAT, Inc. Revised 29 June 1998.

Abstracts
1998 Digestive Disease Week