Long‐Term Outcomes After Total Pancreatectomy: Special Reference to Survivors’ Living Conditions and Quality of Life

• DOI: 10.1007/s00268-015-2948-1
• Publication Date: 2015-01-12T16:42:55Z
• Authors: Yusuke Watanabe; Takao Ohtsuka; Taketo Matsunaga; Hideyo Kimura; Koji Tamura; Noboru Ideno; Teppei Aso; Yoshihiro Miyasaka; Junji Ueda; Shunichi Takahata; Hisato Igarashi; Toyoshi Inoguchi; Tetsuhide Ito; Masao Tanaka
• Keywords: Aged, 80 and over; Blood Glucose; Diarrhea; Glycated Hemoglobin; Male; Blood Glucose Self-Monitoring; Patient Selection; Age Factors; Middle Aged; 3. Good health; Self Care; 03 medical and health sciences; Cross-Sectional Studies; Pancreatectomy; 0302 clinical medicine; Residence Characteristics; Surveys and Questionnaires; Diabetes Mellitus; Quality of Life; Humans; Female; Aged; Retrospective Studies

AbstractBackgroundAlthough recent studies have confirmed the safety of total pancreatectomy (TP), appropriate selection of patients for TP has not been well documented. Because patients require lifelong medical treatment and self‐management of pancreatic insufficiency after TP, indications for TP should be determined carefully according not only to disease factors but also to the social background of patients. We aimed to clarify long‐term outcomes after TP, including the living conditions and quality of life (QoL), of surviving patients.MethodsMedical records of 44 consecutive patients who underwent TP between 1990 and 2013 were reviewed retrospectively; 25 survivors completed cross‐sectional clinical surveys and responded to a questionnaire about QoL using Short Form 36v2.ResultsPrevalence of morbidity and mortality after TP was 32 and 5 %, respectively. Postoperative complications occurred more frequently in elderly patients than in young patients (48 vs. 14 %; P = 0.02); however, there was no significant difference in mortality, postoperative hospital stay, or survival. Twenty‐four of 25 survivors (96 %) could manage pancreatogenic diabetes by themselves, and the median level of glycosylated hemoglobin was 7.4 %. Although one‐third of patients after TP complained of diarrhea and the QoL scores of patients with diarrhea were lower than those of patients without diarrhea, QoL scores after TP were virtually comparable with those of the national population, even in elderly patients.ConclusionsTP can be performed safely, even in elderly patients. QoL after TP seems to be acceptable if patients are capable of self‐management.