PMID- 31562603 OWN - NLM STAT- MEDLINE DCOM- 20200929 LR - 20200929 IS - 1534-4681 (Electronic) IS - 1068-9265 (Linking) VI - 27 IP - 2 DP - 2020 Feb TI - Impact of Endocrine and Exocrine Insufficiency on Quality of Life After Total Pancreatectomy. PG - 587-596 LID - 10.1245/s10434-019-07853-3 [doi] AB - BACKGROUND: Total pancreatectomy (TP) is rarely performed due to concerns for endocrine and exocrine insufficiency and decreased quality of life (QoL). Renewed interest is seen in recent years, but large cohort studies remain scarce. This study was designed to evaluate endocrine and exocrine insufficiency after TP and its impact on QoL. METHODS: Adult patients (age >/= 18 years) who underwent TP between 2008 and 2017 at Karolinska University Hospital with at least 6 months follow-up were included. Endocrine and exocrine insufficiency and QoL were assessed using validated questionnaires (EORTC QLQ-C30, QLQ-PAN26, PAID20, and DTSQs). Both pre- and postoperative questionnaires were available in a subgroup. RESULTS: Of 145 TP, 60 patients were eligible of whom 53 (88.3%) with a median of 21 months (interquartile range [IQR] 13-54) follow-up were included. Symptomatic hypoglycemia occurred in 90.6% (48/53) of patients, and 25% (12/48) experienced >/= 1 episodes of loss of consciousness. The PAID20 revealed emotional burnout in seven patients (13.2%), whereas a high satisfaction score of diabetes treatment (median 28, IQR 24-32) was measured according to the DTSQs. Overall, 27 patients (50.9%) reported to have steatorrhea during a median of 2 days (IQR 0-4) in the past week. Overall QoL was reduced compared with a general population (66.7% vs. 76.4%; Delta9.7%) but did not differ with preoperative outcomes (n = 39, 66.7%; IQR 41.7-83.3 vs. 66.7%, IQR 50.0-83.3; P = 0.553) according to the EORTC QLQ-C30. CONCLUSIONS: Although the impact of endocrine and exocrine insufficiency on QoL after TP seems acceptable, the management of both insufficiencies should be further improved. FAU - Stoop, Thomas F AU - Stoop TF AD - Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. AD - Pancreatic Surgery Unit, Division of Surgery, CLINTEC, Karolinska Institute at Center for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden. FAU - Ateeb, Zeeshan AU - Ateeb Z AD - Pancreatic Surgery Unit, Division of Surgery, CLINTEC, Karolinska Institute at Center for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden. FAU - Ghorbani, Poya AU - Ghorbani P AD - Pancreatic Surgery Unit, Division of Surgery, CLINTEC, Karolinska Institute at Center for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden. FAU - Scholten, Lianne AU - Scholten L AD - Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. FAU - Arnelo, Urban AU - Arnelo U AD - Pancreatic Surgery Unit, Division of Surgery, CLINTEC, Karolinska Institute at Center for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden. FAU - Besselink, Marc G AU - Besselink MG AD - Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. FAU - Del Chiaro, Marco AU - Del Chiaro M AD - Pancreatic Surgery Unit, Division of Surgery, CLINTEC, Karolinska Institute at Center for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden. marco.delchiaro@ucdenver.edu. AD - Division of Surgical Oncology, Department of Surgery, University of Colorado Anschutz Medical Campus, Denver, CO, USA. marco.delchiaro@ucdenver.edu. AD - University of Colorado Cancer Center, Denver, CO, USA. marco.delchiaro@ucdenver.edu. LA - eng PT - Journal Article DEP - 20190927 PL - United States TA - Ann Surg Oncol JT - Annals of surgical oncology JID - 9420840 SB - IM MH - Adolescent MH - Adult MH - Aged MH - Aged, 80 and over MH - Cohort Studies MH - Diabetes Mellitus/pathology/*surgery MH - Endocrine System Diseases/etiology/pathology/*psychology MH - Exocrine Pancreatic Insufficiency/etiology/pathology/*psychology MH - Female MH - Follow-Up Studies MH - Humans MH - Islets of Langerhans/*pathology MH - Male MH - Middle Aged MH - Pancreatectomy/*adverse effects MH - Pancreatic Neoplasms/pathology/*surgery MH - Prognosis MH - *Quality of Life MH - Surveys and Questionnaires MH - Young Adult EDAT- 2019/09/29 06:00 MHDA- 2020/09/30 06:00 CRDT- 2019/09/29 06:00 PHST- 2019/08/01 00:00 [received] PHST- 2019/09/29 06:00 [pubmed] PHST- 2020/09/30 06:00 [medline] PHST- 2019/09/29 06:00 [entrez] AID - 10.1245/s10434-019-07853-3 [pii] AID - 10.1245/s10434-019-07853-3 [doi] PST - ppublish SO - Ann Surg Oncol. 2020 Feb;27(2):587-596. doi: 10.1245/s10434-019-07853-3. Epub 2019 Sep 27.