Effects of pancreatectomy on nutritional state, pancreatic function, and quality of life over 5 years of follow up

Background: To analyze serial changes in nutritional status, pancreatic function, and quality of life (QoL) over 5 years of follow-up after pancreatectomy. Methods: Patients undergoing pancreaticoduodenectomy (PD) or distal pancreatectomy (DP) between 2007 and 2013 were included. Data on relative body weight (RBW); triceps skinfold thickness (TSFT); body mass index (BMI); serum protein, albumin, transferrin, fasting blood glucose, postprandial 2-h glucose, and stool elastase levels; and QoL questionnaire scores were collected serially for 5 years. Results: Two hundred and seventeen patients were enrolled, but 79 patients completed the 5-year follow-up. RBW, BMI, and TSFT continued to decrease postoperatively but increased after 6 months. Transferrin, albumin, and protein levels recovered to the preoperative level after 3 months. Multivariate analysis revealed that a BMI >25 kg/m², DP, and adjuvant therapy had a significant impact on endocrine pancreatic insufficiency. Although steatorrhea and diarrhea were mainly resolved by 12 months, the stool elastase level decreased after PD and was not restored. The mean scores for all QoL questionnaires improved above the preoperative value at 12 months. Conclusions: Patients undergoing pancreatectomy can return to their daily lives after 12 months. However, those with risk factors associated with pancreatic function and QoL need more careful follow-up and supportive management.