传统上，无手术并发症被用来定义胰腺手术后的成功恢复。然而，患者报告的结果测量作为具有挑战性的恢复指标可能优于客观发病率。本研究旨在评估患者报告的结果在评估胰腺手术后恢复情况中的用途。在 2016 年至 2018 年期间前瞻性地招募了计划接受胰十二指肠切除术的患者。在术前和术后几天使用线性模拟自我评估问卷收集患者报告的结果2、7、14、30 以及每月一次，直至 6 个月。患者还被询问在 30 天和 6 个月时是否感觉完全康复。前瞻性评估 30 天的手术发病率，并使用 30 天的综合并发症指数将发病率分类为主要或多种轻微并发症（综合并发症指数≥26.2）与无并发症（综合并发症指数<26.2）。报告了具有临床意义的国际胰腺手术研究组 B 级和 C 级胰瘘和胃排空延迟。 χ2 和 Kruskal-Wallis 检验用于评估与 6 个月恢复和整个术后期间生活质量的关联。 在符合纳入标准并入组的 116 名患者中，32 名 (28%) 出现严重或多种轻微并发症（综合并发症）指数≥26.2）。总体而言，只有不到十分之一的患者 (7%) 报告在术后 30 天感觉完全康复，而 55% 的患者报告在 6 个月后感觉完全恢复。在患有严重疾病的患者中，62% 的患者在 6 个月内未康复，而无并发症组中有 38% 的患者报告在 6 个月内未康复 (P = .03)。与没有胃排空延迟的患者相比，经历过胃排空延迟的患者在 1 个月时生活质量评分较低 (P = .04)，但这种情况在 6 个月时并未持续 (P = .80)。术后胰瘘与 1 个月或 6 个月的生活质量无关（均 P > .05）。在无并发症的患者中，年龄、性别、手术方法和癌症状态与 6 个月时恢复失败无关（所有 P > .05），而健康的患者（美国麻醉医师协会 1-2）报告完全康复的可能性较小恢复（42% vs 69% 美国麻醉医师协会 3-4，P = .04）。除了较高的术前疼痛评分（6 个月时未完全康复的患者平均为 2.3 [标准差 2.4]，完全康复的患者平均为 1.6 [2.2]，P = 0.04）外，术前患者报告的结果与失败无关6 个月时恢复（所有 P > .05）。然而，较低的 30 天生活质量、社交活动、疼痛和疲劳评分与 6 个月时的不完全恢复有关。超过三分之一的病程不复杂的患者在 6 个月时感觉没有从胰腺手术中完全恢复；手术并发症的存在并不普遍与恢复失败相对应。对于有并发症的患者，胃排空延迟似乎比术后胰瘘更能显着提高生活质量。在康复无并发症的患者中，健康的患者在 6 个月时报告完全康复的可能性较小。三十天患者报告的结果或许能够识别出存在长期不完全恢复风险的患者。版权所有 © 2024 Elsevier Inc. 保留所有权利。

The absence of surgical complications has traditionally been used to define successful recovery after pancreas surgery. However, patient-reported outcome measures as metrics of a challenging recovery may be superior to objective morbidity. This study aims to evaluate the use of patient-reported outcomes in assessing recovery after pancreas surgery.Patients scheduled for pancreatoduodenectomy were prospectively enrolled between 2016 to 2018. Patient-reported outcomes were collected using the linear analog self-assessment questionnaire preoperatively and on postoperative days 2, 7, 14, 30, and monthly until 6 months. Patients were also asked if they felt fully recovered at 30 days and 6 months. Thirty-day surgical morbidity was prospectively assessed, and the comprehensive complication index at 30 days was used to categorize morbidity as major or multiple minor complications (comprehensive complication index ≥26.2) vs uncomplicated (comprehensive complication index <26.2). Clinically significant International Study Group Pancreas Surgery Grade B and C pancreatic fistulas and delayed gastric emptying were reported. χ2 and Kruskal-Wallis tests were used to assess associations with recovery by 6 months and quality of life throughout the postoperative period.Of 116 patients who met inclusion criteria and were enrolled, 32 (28%) had major or multiple minor complications (comprehensive complication index ≥26.2). Overall, fewer than 1 in 10 patients (7%) reported feeling fully recovered at 30 days postoperatively, whereas 55% reported feeling fully recovered at 6 months. Of patients suffering major morbidity, 62% did not recover by 6 months, whereas 38% of those in the uncomplicated group reported not being recovered at 6 months (P = .03). Patients who experienced delayed gastric emptying reported low quality-of-life scores at 1 month (P = .04) compared to those with no delayed gastric emptying, but this did not persist at 6 months (P = .80). Postoperative pancreatic fistula was not associated with quality of life at 1 or 6 months (both P > .05). In the uncomplicated patients, age, sex, surgical approach, and cancer status were not associated with failed recovery at 6 months (all P > .05), and healthier patients (American Society of Anesthesiologists 1-2) were less likely to report complete recovery (42% vs 69% American Society of Anesthesiologists 3-4, P = .04). With the exception of higher preoperative pain scores (mean 2.3 [standard deviation 2.4] among patients not fully recovered at 6 months vs 1.6 [2.2] among those fully recovered, P = .04), preoperative patient-reported outcomes were not associated with failed recovery at 6 months (all P > .05). However, lower 30-day quality of life, social activity, pain, and fatigue scores were associated with incomplete recovery at 6 months.More than 1 in 3 patients with an uncomplicated course do not feel fully recovered from pancreas surgery at 6 months; the presence of surgical complications did not universally correspond with recovery failure. In patients with complications, delayed gastric emptying appears to drive quality of life more significantly than postoperative pancreatic fistula. In patients with uncomplicated recovery, healthier patients were less likely to report full recovery at 6 months. Thirty-day patient-reported outcomes may be able to identify patients who are at risk of incomplete long-term recovery.Copyright © 2024 Elsevier Inc. All rights reserved.