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

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

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.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anxiety / etiology
  • Decision Making*
  • Fear
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pancreatectomy
  • Pancreatic Cyst / pathology
  • Pancreatic Cyst / psychology
  • Pancreatic Cyst / surgery*
  • Pancreatic Neoplasms / pathology
  • Pancreatic Neoplasms / psychology
  • Pancreatic Neoplasms / surgery*
  • Patient Satisfaction*
  • Surveys and Questionnaires
  • Young Adult