Hospitalization, frequency of interventions and quality of life after endoscopic, surgical or conservative treatment in patients with chronic pancreatitis

Aim. Comparative analysis of the long-term results of surgical treatment of patients with chronic pancreatitis. Methods. The study included patients with complicated clinical forms of chronic pancreatitis including: ductal pancreatic hypertension, main pancreatic duct concrements, marked fibrous restructuring of the pancreatic parenchyma and presence of calcifications, presence of biliary hypertension, portal hypertension syndrome, duodenostasis syndrome, chronic abdominal pain syndrome, retention and post-necrotic cysts. Patients were divided into 3 groups: group 1 included patients with chronic pancreatitis receiving conservative treatment (n=32), group 2 - patients who underwent the Frey pancreatic resection (n=24) and group 3 - Beger pancreatic resection (n=9). The assessment was performed according to the most spread specific questionnaire in gastroenterology GSRS (Gastrointestinal Symptom Rating Scale). Results. The quality of life of patients who underwent both Frey and Beger pancreatic resection was significantly higher than the quality of life of patients in whom chronic pancreatitis was treated conservatively. Quality of life of patients who underwent Frey or Beger pancreatic resection did not differ significantly. Malabsorption syndrome has a significant effect on the quality of life of patients who underwent surgical treatment of chronic pancreatitis. The GSRS questionnaire demonstrated low sensitivity in detecting malabsorption syndrome. Conclusion. Quality of life of patients who underwent surgical treatment of chronic pancreatitis is statistically significantly higher than in patients receiving conservative treatment; correction of existing quality of life questionnaires is required in order to identify malabsorption syndrome.

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Clinical efficacy of Meteospasmyl in treatment of painful abdominal and dyspeptic syndromes in patients with chronic pancreatitis

Medical alphabet ◽

10.33667/2078-5631-2019-2-13(388)-5-12 ◽

2019 ◽

Vol 2 (13) ◽

pp. 5-12

Author(s):

V. B. Grinevich ◽

Yu. A. Kravchuk ◽

V. I. Ped’ ◽

G. G. Rodionov ◽

I. I. Shantyr’ ◽

...

Keyword(s):

Quality Of Life ◽

Abdominal Pain ◽

Chronic Pancreatitis ◽

Conservative Treatment ◽

Clinical Efficacy ◽

Intestinal Microbiota ◽

Pancreatic Diseases ◽

Complex Therapy

The presented study is devoted to one of the urgent problems of the conservative treatment of chronic pancreatitis — relief of painful abdominal and dyspeptic syndromes. Polymorphism of the etiopathogenetic variants of the formation of pancreatic diseases naturally justifies the need for complex therapy, including secretolytics, antispasmodics medications and polyenzyme drugs. The use of Meteospasmyl in complex therapy effectively relieves abdominal pain and dyspepsia, modifies the composition of the intestinal microbiota and improves the quality of life in patients with chronic pancreatitis.

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Hospitalization, Frequency of Interventions, and Quality of Life after Endoscopic, Surgical, or Conservative Treatment in Patients with Chronic Pancreatitis

World Journal of Surgery ◽

10.1007/s00268-010-0713-z ◽

2010 ◽

Vol 34 (11) ◽

pp. 2642-2647 ◽

Cited By ~ 17

Author(s):

Karoline Rutter ◽

A. Ferlitsch ◽

T. Sautner ◽

A. Püspök ◽

P. Götzinger ◽

...

Keyword(s):

Quality Of Life ◽

Chronic Pancreatitis ◽

Conservative Treatment

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Deterioration of quality of life in patients with chronic pancreatitis

Gastroenterology ◽

10.1016/s0016-5085(01)83218-2 ◽

2001 ◽

Vol 120 (5) ◽

pp. A647-A647

Author(s):

M WEHLER ◽

R NICHTERLEIN ◽

B FISCHER ◽

M FARNBACHER ◽

U REULBACH ◽

...

Keyword(s):

Quality Of Life ◽

Chronic Pancreatitis

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Clinical characteristics and quality of life among Sri Lankan patients with chronic pancreatitis

Journal of International Medical Research ◽

10.1177/0300060520979875 ◽

2020 ◽

Vol 48 (12) ◽

pp. 030006052097987

Author(s):

Umesh Jayarajah ◽

Thisaru Widyarathne ◽

Metthananda Nawarathne ◽

Sivananthan Raguvaran ◽

Nishanthan Subramaniam ◽

...

Keyword(s):

Quality Of Life ◽

Weight Loss ◽

Chronic Pancreatitis ◽

Clinical Characteristics ◽

Considerable Proportion ◽

Intractable Pain ◽

Life Questionnaire ◽

European Organization ◽

Loss Of Appetite

Objective We aimed to describe the clinical characteristics of chronic pancreatitis (CP) and patient quality of life (QOL) in a resource-limited setting. Methods We performed a cross-sectional study including patients with clinical and radiological features of CP. We collected clinical data and assessed QOL using the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire. Results We included 103 patients (median age 44 years, 84 men). Median age at symptom onset was 36 (4–78) years. Around 70% of patients had diabetes mellitus and 62.1% had consumed alcohol; 36 (35%) were current smokers. The mean overall global QOL score was 68.7. Most patients (91.3%) sought treatment from multiple centers. Nineteen (18.5%) had pancreatic stone disease, 38 (36.9%) had persistent abdominal pain (median severity 7.8/10, 59 (57.3%) had steatorrhea, and 56 (54.4%) had jaundice. Poor QOL was significantly associated with weight loss, loss of appetite, and intractable pain. No correlation with age, sex, or alcohol consumption was noted. Conclusion A considerable proportion of patients with CP had troublesome symptoms. Intractable pain, loss of appetite, and weight loss were significantly associated with poor QOL. Further assessment is needed of patients’ psychosocial well-being and its association with QOL.

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Improving the quality of life of patients with breast cancer-related lymphoedema by lymphaticovenous anastomosis (LVA): study protocol of a multicentre randomised controlled trial

BMJ Open ◽

10.1136/bmjopen-2019-035337 ◽

2020 ◽

Vol 10 (1) ◽

pp. e035337 ◽

Cited By ~ 1

Author(s):

Joost Wolfs ◽

Jop Beugels ◽

Merel Kimman ◽

Andrzej A Piatkowski de Grzymala ◽

Esther Heuts ◽

...

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Lymph Node ◽

Randomised Controlled Trial ◽

Conservative Treatment ◽

Cancer Treatment ◽

Controlled Trial ◽

Breast Cancer Treatment ◽

Randomised Controlled

IntroductionEarly breast cancer detection and advancements in treatment options have resulted in an increase of breast cancer survivors. An increasing number of women are living with the long-term effects of breast cancer treatment, making the quality of survivorship an increasingly important goal. Breast cancer-related lymphoedema (BCRL) is one of the most underestimated complications of breast cancer treatment with a reported incidence of 20%. A microsurgical technique called lymphaticovenous anastomosis (LVA) might be a promising treatment modality for patients with BCRL. The main objective is to assess whether LVA is more effective than the current standard therapy (conservative treatment) in terms of improvement in quality of life and weather it is cost-effective.Methods and analysisA multicentre, randomised controlled trial, carried out in two academic and two community hospitals in the Netherlands. The study population includes 120 women over the age of 18 who have undergone treatment for breast cancer including axillary treatment (sentinel lymph node biopsy or axillary lymph node dissection) and/or axillary radiotherapy, presenting with an early stage lymphoedema of the arm, viable lymphatic vessels and received at least 3 months conservative treatment. Sixty participants will undergo the LVA operation and the other sixty will continue their regular conservative treatment, both with a follow-up of 24 months. The primary outcome is the health-related quality of life. Secondary outcomes are societal costs, quality adjusted life years, cost-effectiveness ratio, discontinuation rate of conservative treatment and excess limb volume.Ethics and disseminationThe study was approved by the Ethics Committee of Maastricht University Medical Center (METC) on 19 December 2018 (NL67059.068.18). The results of this study will be disseminated in presentations at academic conferences, publications in peer-reviewed journals and other news media.Trial registration numberNCT02790021; Pre-results.

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Would integrating women's professional care of pelvic organ prolapse improve the symptoms and quality of life: an integrative literature review

Journal of Integrated Care ◽

10.1108/jica-07-2019-0032 ◽

2020 ◽

Vol 28 (2) ◽

pp. 119-133

Author(s):

Nicola Davies ◽

Teresa Burdett

Keyword(s):

Quality Of Life ◽

Pelvic Organ Prolapse ◽

Conservative Treatment ◽

Conservative Management ◽

Integrated Approach ◽

Pelvic Organ ◽

Social Implications ◽

Content Type ◽

Practical Implications

PurposeIntegrated healthcare is a central tenant of the NHS Long Term Plan (NHS, 2019). NICE in 2019 published guidelines; advising the integration of multidisciplinary professionals which may lead to an improvement in conservative treatment methods of pelvic organ prolapse. Therefore, current literature on the conservative treatments for pelvic organ prolapse needs to be reviewed to ascertain if an integrated approach would improve the symptoms and quality of life for women.Design/methodology/approachA systematic review of the literature between 2013 and 2018 was implemented. Papers included were written in English, peer-reviewed and consisted of treatments of pelvic organ prolapse in women. Papers containing surgical interventions, postpartum participants, reviews, evaluations, guidelines, follow-up studies, focusing on cost effectiveness, sexual function were excluded.FindingsSeven studies in total were included, and two overarching themes were identified: quality of life after treatment and the effect of conservative treatment on pelvic organ prolapse symptoms. The literature suggested that integrating care had a more positive outcome on pelvic organ symptoms and quality of life.Research limitations/implicationsTo develop a robust enhanced model of care for conservative treatment of pelvic organ prolapse through more mixed method or qualitative research, that incorporates integrative treatment methods with collaboration from multidisciplinary professionals.Practical implicationsThe practical implications of integrating the conservative management of pelvic organ prolapse is the communication between the multidisciplinary team must be exceptional to ensure everyone understands and agrees the treatment that is being provided to patient. Also, effective teamwork is important to ensure the patient receives the best care with input from the correct disciplines. The multi-professional team will need to have regular meetings to discuss and implement care plans for patients that might prove difficult to schedule due to differing commitments and priorities. This must be overcome to insure a successful and effective integrated approach to pelvic organ prolapse is delivered.Social implicationsThe social implications of integrating the professional approach to women's care of pelvic organ prolapse involves reducing the severity of the symptoms therefore, increasing the quality of life. This may result in the reduction of surgical intervention due to the patient being satisfied with the conservative management. Through integrating the management of the prolapse the patient will receive an accessible individualised care plan pathway that focuses on treating or reducing the impact of the symptoms that are bothersome to the patient whilst managing patient expectations. Patients will also, be reassured by the number of multi-disciplinary professionals involved in their care.Originality/valueGlobal integration of conservative treatments and multidisciplinary-professionals specialising in pelvic organ prolapse and pelvic floor dysfunction is needed.

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Strengthening the pharmacological potential of drug therapy in treatment of patients with chronic pancreatitis by using therapeutic physical factors

Fizioterapevt (Physiotherapist) ◽

10.33920/med-14-2012-01 ◽

2020 ◽

pp. 8-14

Author(s):

R. M. Mallaeva ◽

A. N. Makhinko ◽

M. B. Uzdenov

Keyword(s):

Quality Of Life ◽

Chronic Pancreatitis ◽

Drug Therapy ◽

Clinical Manifestations ◽

Medical Rehabilitation ◽

Control Group ◽

Physical Factors ◽

Standard Drug ◽

Pharmacological Potential

The purpose of the study is to improve rehabilitation treatment of patients with chronic pancreatitis (CP) at inpatient stage by strengthening pharmacological potential of drug therapy due to inclusion of therapeutic physical factors (TPF) in therapeutic programs. Materials and methods. 159 patients with acute CP were observed. By simple randomization, 4 groups were formed: the control group (MG, 39 people) received standard drug therapy; 1st comparison group (GC1; 38 people) additionally received TPF; GC2 (40 people) in addition to treatment in GC1 had drinking mineral water «Slavyanovskaya»; in main group (42 people) in addition to the treatment in GC2 got preformed peloidotherapy on the cervical-collar zone. All the patients underwent the evaluation of clinical score and quality of life before and after medical rehabilitation. Results. In MG, clinical symptomatology leveling was by 78,2% (p<0,01), in GC1 — by 71,5% (p<0,01), GC2 — by 62,3% (p<0,01), CG — by 57,2% (p<0,01) on average immediately after the treatment, which was in a clear correlation with indicators of quality of life. In the long term (in 6 and 12 months), the advantage of combination therapy was noted with the same validity, the preservation of the achieved positive result was mostly noted in the MG: after 6 months the improvement in physical health compared to the initial values was noted by 34,4% (p<0,01), after 12 months — by 24,0% (p<0,05); mental — by 32,3% (p<0,01) and 22,5% (p<0,05), respectively. In both comparison groups, positive dynamics was 10–12% lower, and in the control group, after 6 months, there was only a tendency to improve quality of life indicators. Conclusion. The inclusion of TPF in the programs of the inpatient stage of medical rehabilitation of patients with chronic pancreatitis by strengthening the pharmacological potential of drug therapy contributes to the leveling of clinical manifestations (abdominal pain, dyspepsia and diarrhea), the result of which is an improvement in the quality of life of this category of patients.

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