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Quality of Life Associated with Open vs Minimally Invasive Pancreaticoduodenectomy: A Prospective Pilot Study.

Publication ,  Journal Article
Moris, D; Rushing, C; McCracken, E; Shah, KN; Zani, S; Perez, A; Allen, PJ; Niedzwiecki, D; Fish, LJ; Blazer, DG
Published in: J Am Coll Surg
April 1, 2022

BACKGROUND: This prospective study was designed to compare quality of life (QoL) among patients who underwent open (O-PD) vs minimally invasive pancreaticoduodenectomy (MI-PD), using a combination of validated qualitative and quantitative methodologies. STUDY DESIGN: From 2017 to 2019, patients scheduled for pancreaticoduodenectomy (PD) were enrolled and presented with Functional Assessment of Cancer Therapy-Hepatobiliary surveys preoperatively, before discharge, at first postoperative visit and approximately 3 to 4 months after operation ("3 months"). Longitudinal plots of median QoL scores were used to illustrate change in each score over time. In a subset of patients, content analysis of semistructured interviews at postoperative time points (1.5 to 6 months after operation) was conducted. RESULTS: Among 56 patients who underwent PD, 33 had an O-PD (58.9%). Physical and functional scores decreased in the postoperative period but returned to baseline by 3 months. No significant differences were found in any domains of QoL at baseline and in the postoperative period between patients who underwent O-PD and MI-PD. Qualitative findings were concordant with quantitative data (n = 14). Patients with O-PD and MI-PD reported similar experiences with complications, pain, and wound healing in the postoperative period. Approximately half the patients in both groups reported "returning to normal" in the 6-month postoperative period. A total of 4 patients reported significant long-term issues with physical and functional well-being. CONCLUSIONS: Using a novel combination of qualitative and quantitative analyses in patients undergoing PD, we found no association between operative approach and QoL in patients who underwent O-PD vs MI-PD. Given the increasing use of minimally invasive techniques for PD and the steep learning curve associated with these techniques, continued assessment of patient benefit is critical.

Duke Scholars

Published In

J Am Coll Surg

DOI

EISSN

1879-1190

Publication Date

April 1, 2022

Volume

234

Issue

4

Start / End Page

632 / 644

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Surgery
  • Quality of Life
  • Prospective Studies
  • Postoperative Complications
  • Pilot Projects
  • Pancreaticoduodenectomy
  • Pancreatic Neoplasms
  • Humans
  • 3202 Clinical sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Moris, D., Rushing, C., McCracken, E., Shah, K. N., Zani, S., Perez, A., … Blazer, D. G. (2022). Quality of Life Associated with Open vs Minimally Invasive Pancreaticoduodenectomy: A Prospective Pilot Study. J Am Coll Surg, 234(4), 632–644. https://doi.org/10.1097/XCS.0000000000000102
Journal cover image

Published In

J Am Coll Surg

DOI

EISSN

1879-1190

Publication Date

April 1, 2022

Volume

234

Issue

4

Start / End Page

632 / 644

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Surgery
  • Quality of Life
  • Prospective Studies
  • Postoperative Complications
  • Pilot Projects
  • Pancreaticoduodenectomy
  • Pancreatic Neoplasms
  • Humans
  • 3202 Clinical sciences