Duodenum-preserving laparoscopic resection of pancreatic head leads to better QoL

In patients seeking treatment for pancreatic-head intraductal papillary mucinous neoplasm (IPMN), laparoscopic duodenum-preserving total pancreatic head resection (LDPPHRt) yields comparable perioperative outcomes as laparoscopic pancreaticoduodenectomy (LPD) but results in better quality of life (QoL), reports a recent study.

Researchers conducted a retrospective analysis of 50 patients, of whom 12 were treated with LDPPHRt. Pre- and postoperative data were comparable between the treatment groups.

While exocrine insufficiency occurred in 50.0 percent of LDPPHRt patients, as opposed to only 28.9 percent of LPD comparators, the difference did not satisfy statistical significance (p=0.321). The same was true for endocrine insufficiency (8.3 percent vs 7.9 percent; p=1.000).

In contrast, postoperative quality of life, as measured by the European Organisation for Research and Treatment of Cancer Core Quality of Life questionnaire (EORTC QLQ-C30), was significantly better in the LDPPHRt group, particularly in terms of physical function. LDPPHRt patients achieved a mean score of 96.1, as opposed to only 88.2 in LPD counterparts (p=0.008).

In addition, the average body image score was 65.3 in the LDPPHRt group, as compared with only 43.0 in the LPD arm (p=0.039). Digestive symptom scores were also significantly better in the LDPPHRt group (5.5 vs 28.9; p=0.004).

“At present, we conclude that LDPPHRt is a safe and feasible operation, and the short-term outcomes are comparable to those of LPD,” the researchers said. “Patients who underwent LDPPHRt experienced a more favorable quality of life after surgery compared to LPD.”