Modified Puestow procedure - a follow-up study, quality of life assessment

<b>Introduction:</b> Chronic pancreatitis (CP) is a devastating and painful disease often leading to significant impairment of the patient's quality of life (QOL). Lateral pancreaticojejunostomy/modified Puestow procedure (LPJ) is a procedure of choice in CP when conservative treatment fails. The main goal of this surgery is to alleviate pain. <br><b>Aim:</b> The aim of this study was to assess patients' QOL after LPJ in a short- and long-term follow-up using a disease-specific QOL questionnaire. <br><b>Materials and methods:</b> The study involved a population of patients after LPJ operated on between 2011 and 2018. They were evaluated the day before surgery and followed up for 6 and 12 months after surgery. For QOL assessment we used the core questionnaire EORTC-QLQ-C30 version 3.0 and ECRTC-QLQ-PAN26. Peripheral blood samples were taken from subjects and morphological and biochemical parameters, as well as tumor markers, were obtained. <br><b>Results:</b> The study included 29 patients (16 males and 13 females) who underwent LPJ due to CP with dilatation of the pancreatic duct without calculi. The age of study subjects ranged from 19 to 71 years, with a mean value of 48 (SD 13.7) years. We managed to collect a total of 47 questionnaires. We did not observe significant changes in tumor markers, biochemical parameters (pancreatic and hepatic), or morphology in our cohort. Global health status (mean [SD]: 54.17 [17.53] vs. 56.41 [24.09] vs. 59.52 [27.42]) and body image (mean [SD]: 34.52 [23.08] vs. 42.31 [35.10] vs. 50 [30.73]) improved in our study group but this improvement was not statistically significant. Other results were mostly inferior but with a tendency to stabilize in time. <br><b>Conclusions:</b> Our findings suggest that stabilization of CP symptoms can occur after a modified Puestow procedure. Considering a typical progression of this disease - worsening with time - this result may be a promising option, especially when other treatments fail to ease the symptoms.