Effect of gastrointestinal reconstruction on quality of life and nutritional status after pylorus-preserving pancreatoduodenectomy

A total of 31 Japanese patients who underwent pylorus-preserving pancreatoduodenectomy from January 1998 through September 2000 were studied regarding quality of life and nutritional status before and within two months (short term) and six months to one year (long term) after surgery. Quality of life was estimated using a questionnaire consisting of 23 items (13 physical and 10 psychosocial domains). Nutritional status was assessed by body weight, hemoglobin concentration, serum concentration of albumin and cholesterol, and pancreatic function. These data were compared between 18 patients with end-to-end (Imanaga) and 13 with end-to-side (Traverso) gastrointestinal reconstruction. In both groups, physical quality of life scores dropped at short term, and then returned to the normal level at long term after operation, showing mostly parallel changes with the parameters of nutritional status. However, the scores of psychosocial conditions, which reflected the patient's mental health, remained low even at long term in both groups. The values of these parameters showed no statistical difference between the two groups at each time point. Postoperative quality of life and nutritional status were not different between Imanaga and Traverso reconstructions after pylorus-preserving pancreatoduodenectomy and mental health care would be necessary for at least one year after operation in both groups.