Long-Term Assessment of Pancreatic Function After Pancreatectomy for Cystic Neoplasms.

Autor: Shah KP; Michael E DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas., Baugh KA; Michael E DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas., Brubaker LS; Michael E DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas., Van Buren G 2nd; Michael E DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas., Villafane-Ferriol N; Michael E DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas., McElhany AL; Michael E DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas., Mohamed S; Michael E DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas., Silberfein EJ; Michael E DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas., Hsu C; Michael E DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas., Massarweh NN; Michael E DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas., Tran Cao HS; Michael E DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas., Mendez-Reyes JE; Michael E DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas., Fisher WE; Michael E DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas. Electronic address: wfisher@bcm.edu.
Jazyk: angličtina
Zdroj: The Journal of surgical research [J Surg Res] 2020 Mar; Vol. 247, pp. 547-555. Date of Electronic Publication: 2019 Nov 15.
DOI: 10.1016/j.jss.2019.09.045
Abstrakt: Background: With advances in cross-sectional imaging, pancreatic cysts are more frequently diagnosed and have become a common indication for pancreatectomy. The impact of pancreatectomy in these patients is important. The purpose of this study was to assess short-term outcomes, long-term nutritional status, quality of life (QOL), and pancreas function after pancreatectomy for cystic neoplasms.
Materials and Methods: At a single institution, patients at least 3 y post-pancreatectomy for benign cystic neoplasms were identified. Using a validated questionnaire, short-term outcomes, long-term outcomes including endocrine and exocrine insufficiency, long-term nutritional status, and preoperative and postoperative QOL were compared based on operation and indication for resection.
Results: Among 102 eligible patients, 70 had valid contact information and 51 (72.9%) agreed to participate. Median follow-up was 6 (4-8) y. Patients undergoing pancreatoduodenectomy for benign cysts had higher morbidity than a similar cohort resected for pancreatic adenocarcinoma (patients with at least 1 ≥ grade 2 complication [49.0% versus 31.6%, P = 0.038]). After long-term follow-up, pancreatectomy did not significantly affect perceived QOL. Half of patients had mild-moderate or severe malnourishment, but pancreatic enzyme replacement was reported by only 4 (7.8%) patients. New-onset diabetes was present in 15 (29.4%) patients with median time-to-diagnosis of 6 (1-12) mo after resection.
Conclusions: Pancreatectomy for benign cysts did not negatively impact patients' perceived QOL. However, after long-term follow-up, malnutrition and pancreatic insufficiency occurred in a significant percentage and may be greater than previously estimated. Consideration of short- and long-term outcomes should factor into preoperative counseling, especially in cysts with minimal risk of progression to malignancy.
(Copyright © 2019. Published by Elsevier Inc.)
Databáze: MEDLINE
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