[Late complications and quality of life after multivisceral surgeries with pancreatoduodenectomy].

Abstract

Objective: To investigate late complications after pancreatoduodenectomy (PD) as a part of multivisceral surgeries (MVS) and the impact of these interventions on the quality of life.

Material and methods: Analysis of complications in long-term postoperative period included 776 patients (233 cases of MVS with PD (main group) and 543 cases of standard PD (comparison group)). Analysis of the quality of life included 58 patients from the main group and 67 patients from the comparison group. The quality of life was studied using the Russian-language versions of the EORTC QLQ-C30 and EORTC QLQ-PAN26 questionnaires.

Results. t: Here were no significant between-group differences in the incidence of long-term postoperative complications (26.2% versus 20.1%, p=0.059). Diabetes mellitus occurred in 26 (15.9%) and 57 (10.8%) patients, respectively (p=0.08). Malnutrition (10.3% versus 3%, p<0.001), cholangitis (7.3% versus 2.5%, p=0.003) and edema/ascites (7.3% versus 0.8%, p<0.001) were significantly more common in the main group. According to the EORTC QLQ-C30 scores in the main group, general health (58 (58 - 58) versus 66 (58 - 66), p<0.001, weak clinical significance) and physical functions (79.5 (73 - 89) versus 86 (73 - 93), p=0.04, weak clinical significance) were significantly worse, and weakness was more pronounced (22 (22 - 33) versus 11 (11 - 22), p<0.001, moderate clinical significance). According to the EORTC QLQ-PAN26 scores, weight loss (24.5 (16-33) versus 16 (0-16), p<0.001, weak clinical significance), weakness in arms and legs (16 (16-16) versus 0 (0-16), p<0.001, moderate clinical significance) and dry mouth (8 (0-16) versus 0 (0-16), p=0.004, weak clinical significance) were more common in the main group.

Conclusion: MVS with PD is significantly more often accompanied by cholangitis and symptoms of alimentary failure in long-term period. This determines the worst quality of life after MVS with PD.