Factors associated with changes in quality of life after pancreaticoduodenectomy for periampullary tumors.

INTRODUCTION

Pancreaticoduodenectomy for periampullary tumors is a complex surgery with potential complications and long recovery, impacting patients' quality of life (QoL). This study evaluates QoL changes from preoperative status to 12 months post-surgery.

METHODS

A prospective cohort study was conducted at the University Medical Center of Ho Chi Minh City from January 2019 to May 2021. Patients undergoing pancreaticoduodenectomy (laparoscopic or open) were assessed using the SF-36 questionnaire at baseline, 1, 3, 6 and 12 months post-discharge. Exclusion criteria included total pancreatectomy, in-hospital mortality and disease recurrence. Data on demographics, comorbidities, tumor staging, complications and survival were analyzed using SPSS 20.0, with paired Wilcoxon tests and regression models.

RESULTS

Among 111 patients (64 males, mean age 57 ± 12.2 years), 44 had pancreatic head cancer and 21 had ampullary cancer. Laparoscopic surgery was performed in 66 cases. Postoperative fistulas occurred in 30.6%, with one severe case. Median hospital stay was 11 ± 5 days, and average disease-free survival was 20.42 ± 13.4 months. QoL declined at 1 month post-surgery (Physical: 67.29 to 54.69, p = 0.04; and Emotional limitations: 70.17 to 54.18, p = 0.01) but improved from 3 months onward, surpassing pre-treatment levels. Malignancy, comorbidities, cholangitis and postoperative complications negatively impacted QoL.

CONCLUSION

QoL decreases initially after pancreaticoduodenectomy but stabilizes and improves after 3 months. Preoperative and postoperative management of risk factors may enhance recovery and QoL outcomes.