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Health-related quality of life and long-term outcomes after endoscopic therapy for walled-off pancreatic necrosis.
Smith, Zachary L; Gregory, Martin H; Elsner, Jeffrey; Alajlan, Bader A; Kodali, Divya; Hollander, Thomas; Sayuk, Gregory S; Lang, Gabriel D; Das, Koushik K; Mullady, Daniel K; Early, Dayna S; Kushnir, Vladimir M.
Afiliação
  • Smith ZL; Division of Gastroenterology, Washington University School of Medicine, St Louis, USA.
  • Gregory MH; Division of Gastroenterology, Washington University School of Medicine, St Louis, USA.
  • Elsner J; Division of Gastroenterology, Washington University School of Medicine, St Louis, USA.
  • Alajlan BA; Division of Gastroenterology, Washington University School of Medicine, St Louis, USA.
  • Kodali D; Division of Gastroenterology, Washington University School of Medicine, St Louis, USA.
  • Hollander T; Division of Gastroenterology, Washington University School of Medicine, St Louis, USA.
  • Sayuk GS; Division of Gastroenterology, Washington University School of Medicine, St Louis, USA.
  • Lang GD; Division of Gastroenterology, Washington University School of Medicine, St Louis, USA.
  • Das KK; Division of Gastroenterology, Washington University School of Medicine, St Louis, USA.
  • Mullady DK; Division of Gastroenterology, Washington University School of Medicine, St Louis, USA.
  • Early DS; Division of Gastroenterology, Washington University School of Medicine, St Louis, USA.
  • Kushnir VM; Division of Gastroenterology, Washington University School of Medicine, St Louis, USA.
Dig Endosc ; 31(1): 77-85, 2019 Jan.
Article em En | MEDLINE | ID: mdl-30152143
ABSTRACT
BACKGROUND AND

AIM:

Walled-off pancreatic necrosis (WON) frequently develops after necrotizing pancreatitis. Endoscopic drainage has become the preferred modality for symptomatic or infected WON. The aim of the present study was to assess health-related quality of life (HR-QOL) and long-term outcomes in patients undergoing endoscopic drainage for WON.

METHODS:

Patients undergoing endoscopic drainage of WON from January 2006 to May 2016 were identified. Data recorded included demographic information, and the incidence of long-term sequelae including pancreatic endocrine and exocrine insufficiency. Attempts were made to contact all patients. HR-QOL was assessed using the SF-36 questionnaire.

RESULTS:

Eighty patients were analyzed, 41 (51.3%) of whom completed the SF-36. One-year all-cause mortality was 6.2%, and disease-related mortality was 3.7%. A notable proportion of patients developed exocrine insufficiency (32.5%), endocrine insufficiency (27.7%), and long-term opiate use (42.5%). Development of exocrine insufficiency was predictive of lower total SF-36 scores (P = 0.016). Patients with WON had better HR-QOL compared with cohorts of irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD). In patients developing exocrine insufficiency versus healthy controls, poorer scores in the physical role (P < 0.001), general health (P < 0.001), vitality (P = 0.001), and emotional role (P = 0.029) domains were observed. Exocrine insufficiency patients had better HR-QOL than the IBS and IBD cohorts, although these differences were less pronounced.

CONCLUSION:

After undergoing endoscopic drainage for WON, patients have relatively preserved HR-QOL. The subset of patients that develop exocrine insufficiency have significantly poorer HR-QOL compared to healthy controls, although not to the degree of chronic gastrointestinal disorders such as IBS and IBD.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Qualidade de Vida / Drenagem / Pancreatite Necrosante Aguda / Endoscopia Tipo de estudo: Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Dig Endosc Assunto da revista: DIAGNOSTICO POR IMAGEM / GASTROENTEROLOGIA Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Qualidade de Vida / Drenagem / Pancreatite Necrosante Aguda / Endoscopia Tipo de estudo: Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Dig Endosc Assunto da revista: DIAGNOSTICO POR IMAGEM / GASTROENTEROLOGIA Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Estados Unidos