Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver · 2026
Nutritional recovery after minimally invasive pancreatic stone treatment: Body mass index dynamics and predictors in chronic pancreatitis cohorts.
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Liu Yu, Feng Xiao-Yue, Chen Chong, Wang Teng, Yi Jin-Hui, Zhang Song-Lin, Han Pei-Dong, Wang Dan, Wang Fang-Yu, Li Zhao-Shen, Hu Liang-Hao
Аннотация
BACKGROUND AND AIM: This study assessed post-intervention body mass index (BMI) changes and associated risk factors in chronic pancreatitis (CP) patients undergoing minimally invasive treatment for pancreatic stones.
METHODS: This retrospective-prospective cohort study enrolled adult CP patients with painful pancreatic stones (>5 mm) who underwent combined pancreatic extracorporeal shock wave lithotripsy (P-ESWL) followed by endoscopic retrograde cholangiopancreatography between March 2011 and June 2018. Patients were prospectively followed until March 2024. BMI was assessed pre-intervention and at final follow-up. Logistic regression identified independent predictors of post-procedural BMI changes.
RESULTS: Among 1978 patients undergoing P-ESWL, 1562 (79.0 %) with ≥ 1-year follow-up were analyzed. Baseline BMI distribution showed 65.1 % (n = 1017) normal weight (18.5-24.0 kg/m²), 16.9 % (n = 264) overweight/obese (≥24.0 kg/m²), and 18.0 % (n = 281) underweight (<18.5 kg/m²). Post-procedural complication rates were similar across BMI subgroups. During follow-up, 66.8 % (n = 1044) maintained normal BMI, while 33.2 % (n = 518) experienced post-treatment BMI outside the normal range-12.0 % became underweight and 21.2 % overweight/obese. Five independent predictors of post-treatment BMI outside the normal range were identified: baseline BMI status, frequent acute pancreatitis attacks (>1/year), prior severe acute pancreatitis, multiple stones, and CP-related treatment during follow-up.
CONCLUSIONS: Minimally invasive pancreatic stone treatment causes significant BMI changes with identifiable predictors. Integrating metabolic risk stratification into CP management algorithms could optimize long-term outcomes.
METHODS: This retrospective-prospective cohort study enrolled adult CP patients with painful pancreatic stones (>5 mm) who underwent combined pancreatic extracorporeal shock wave lithotripsy (P-ESWL) followed by endoscopic retrograde cholangiopancreatography between March 2011 and June 2018. Patients were prospectively followed until March 2024. BMI was assessed pre-intervention and at final follow-up. Logistic regression identified independent predictors of post-procedural BMI changes.
RESULTS: Among 1978 patients undergoing P-ESWL, 1562 (79.0 %) with ≥ 1-year follow-up were analyzed. Baseline BMI distribution showed 65.1 % (n = 1017) normal weight (18.5-24.0 kg/m²), 16.9 % (n = 264) overweight/obese (≥24.0 kg/m²), and 18.0 % (n = 281) underweight (<18.5 kg/m²). Post-procedural complication rates were similar across BMI subgroups. During follow-up, 66.8 % (n = 1044) maintained normal BMI, while 33.2 % (n = 518) experienced post-treatment BMI outside the normal range-12.0 % became underweight and 21.2 % overweight/obese. Five independent predictors of post-treatment BMI outside the normal range were identified: baseline BMI status, frequent acute pancreatitis attacks (>1/year), prior severe acute pancreatitis, multiple stones, and CP-related treatment during follow-up.
CONCLUSIONS: Minimally invasive pancreatic stone treatment causes significant BMI changes with identifiable predictors. Integrating metabolic risk stratification into CP management algorithms could optimize long-term outcomes.