The Effect of Different Surgical Interventions for Chronic Pancreatitis on Quality of Life and Nutritional State of the Patients

Background: Previously we have successfully validated the EORTC-QLQ C30 and the PAN-26 quality of life questionnaires to measure the quality of life (QOL) of patients with chronic pancreatitis (CP). The hypothesis was that the different procedures appli- cable for the treatment of chronic pancreatitis might affect differently the QOL. The aim of this study was to test QOL in combination with nutritional state (NS) meas- urements to evaluate the effectiveness of different surgical interventions for the treat- ment of CP. Patients and Methods: EORTC-QLQ-C30 and PAN-26 questionnaires were used for QOL measurements. NS was controlled by laboratory tests, standard directly measured and calculated parameters. 66 patients were evaluated before operation, 25 of them were assessed also after the intervention. They all had at least 2 postoperative controls. Average follow-up time in each procedure was 7 months. We grouped the operation techniques as decompressions (DEC), pylorus preserving pancreato-duodenectomy (PPPD), and local head excision with extended decompression (Frey-procedure) (FP). Results: At first we compared the postoperative data of the different interventions with that of the whole preoperative group. FP and the PPPD had significantly (p � 0.05) bet- ter scores in the main QOL questions. The FP showed the worst nutritional recovery result in this comparison. Next we compared the postoperative groups with their own preoperative data. In this case the FP showed significantly better scores in QOL param- eters, while in the DEC group there was no significant improvement. During the aver- age 7 months follow-up there was improvement in the nutritional parameters in each group, but this difference was not significant. In the FP we had an average 4% improve- ment in each NS parameters. On the other hand the PPPD patients showed an average 2% and the DEC group showed only 1% improvement in nutritional recovery. Conclusions: QOL and NS parameters are important and applicable tools to compare the effectiveness of the different surgical procedures. The follow-up of the nutritional recovery can be reliable only if we compare every patient's postoperative results with their own preoperative parameters. The FP seems to be the optimal choice for the sur- gical treatment of severe CP. Pancreatology 2002;2:217-361