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J Gastrointest Surg. 2018 Jan;22(1):88-97. doi: 10.1007/s11605-017-3564-1. Epub 2017 Sep 5.

Decision-Making for the Management of Cystic Lesions of the Pancreas: How Satisfied Are Patients with Surgery?

Author information

1
Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, 19104, USA.
2
Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
3
Department of Surgery, Unit of General and Pancreatic Surgery, University of Verona, Verona, Italy.
4
Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, 19104, USA. Charles.Vollmer@uphs.upenn.edu.

Abstract

INTRODUCTION:

This study aims to understand patients' perspectives and satisfaction with choosing surgery for the treatment of pancreatic cystic lesions (PCLs).

METHODS:

A 62-question survey was administered to 113 patients who had a resection for a PCL by 12 surgeons at two pancreatic specialty centers (2004-2016). Patients' final diagnoses and perioperative outcomes were correlated to the survey's results using univariate analysis.

RESULTS:

Fear of cancer was quite or extremely important in most respondents' decision to have surgery (95.4%). Respondents were quite or fully satisfied with the outcomes of surgery (91.1%) and with the decision-making process (89.3%). Distress from anxiety about the cyst before surgery (58.6%) largely outweighed that from postsurgical lifestyle changes (14.4%). Furthermore, 88.7% of patients with pathologically non-malignant disease were quite or fully satisfied with their decision to have surgery, and patients with mucinous neoplasms reported high satisfaction rates independent of grade of dysplasia or malignancy (p = 0.641).

CONCLUSION:

Patients with a resected PCL are highly satisfied with their decision to have surgery, regardless of the final diagnosis or clinical outcome. Fear of cancer is the main driver in the decision-making process, and the anxiety of harboring a cyst is a greater cause of distress than are postsurgical lifestyle changes.

KEYWORDS:

Decision-making; IPMN; Pancreatectomy; Pancreatic cyst; Patient satisfaction

PMID:
28875275
DOI:
10.1007/s11605-017-3564-1
[Indexed for MEDLINE]

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