Symptomatic change and gastrointestinal quality of life after pancreatectomy

Pancreatectomy affects gastrointestinal (GI) symptoms. Our purpose was to assess the quality of life of pancreatectomy patients in relation to GI function.

Pancreatectomy patients were asked qualitative, open-ended questions about symptoms. They also completed the Gastrointestinal Symptom Rating Scale (GSRS) for reflux syndrome, acute pain syndrome, indigestion syndrome, diarrhoea syndrome and constipation syndrome.

A total of 52 patients participated. Of these, 69% reported an improvement and 31% reported no change in preoperative symptoms. No patients reported a worsening of symptoms. Half (50%) of the patients experienced new, different symptoms. Median GSRS scores were 0 for reflux syndrome [interquartile range (IQR): 0-1.0], 0 for acute pain syndrome (IQR: 0-1.0), 2.0 for indigestion syndrome (IQR: 1.0-4.0), 2.0 for diarrhoea syndrome (IQR: 0.5-4.5), and 0 for constipation syndrome (IQR: 0-1.0). Whipple operation patients scored higher on the reflux syndrome (0.5 vs. 0; P= 0.08) and indigestion syndrome (3.5 vs. 1.5; P= 0.06) domains. A total of 68% of Whipple operation patients experienced new symptoms, compared with 32% of patients who had undergone other types of pancreatectomy (P= 0.002). Scores of patients who had undergone surgery <2 years and >2 years earlier, respectively, did not differ.

Patients who underwent pancreatectomy frequently experienced an improvement in preoperative symptoms, but also experienced new postoperative symptoms. This was more common after Whipple operations. However, these symptoms were relatively mild in severity. These mild symptoms seem to persist over time.