Supplementary Material for: Long-term follow-up after surgery for chronic pancreatitis – a bicentric retrospective experience.

Introduction The impact of surgery on nutritional status, pancreatic function and symptoms of patients affected by chronic pancreatitis (CP) has not been unequivocally determined. This study aims to evaluate clinical follow-up after surgery for CP in an Italian-Austrian population. Materials and Methods Patients operated for CP at two high-volume centers between 2000 and 2018 were analysed. The following parameters were compared between the pre- and post-operative period: nutritional status, endocrine and exocrine pancreatic functions and chronic pain. Results Overall, 186 patients underwent surgery for CP. Among these, 68 (40%) answered a specific follow-up questionnaire. The body mass index showed a significant increase between pre-and post-operative assessments (21.1 vs 22.5 p = 0.003). Furthermore, a 60% decrease in the prevalence of chronic pain (81 vs 21%, p < 0.001) was observed. On the contrary, both exocrine and endocrine pancreatic functions pointed towards a worsening after surgery, with consistent higher rates of patients presenting with diabetes mellitus, as well as patients requiring insulin therapy and oral intake of pancreatic enzymes. The analysis of body composition performed on 40 (24%) patients with a complete imaging pack revealed no significant change in the nutritional status after surgery. Discussion/Conclusion Despite the good results observed in terms of pain relief, the surgical approach led to a consistent worsening of the global pancreatic function. No significant influence of surgery on the nutritional status of patients was detected.

引言 慢性胰腺炎（chronic pancreatitis, CP）患者接受手术治疗后，其营养状态、胰腺功能及临床症状的改变尚未得到明确界定。本研究旨在评估意大利-奥地利人群中慢性胰腺炎患者术后的临床随访情况。
材料与方法 本研究纳入2000年至2018年间于两家高容量诊疗中心接受慢性胰腺炎手术治疗的患者，对其临床资料进行分析。比较术前与术后阶段的以下指标：营养状态、内分泌与外分泌胰腺功能，以及慢性疼痛症状。
结果 总计共有186例慢性胰腺炎患者接受手术治疗。其中68例（40%）完成了专属随访问卷。术前与术后评估的体重指数（body mass index, BMI）存在显著升高（21.1 vs 22.5，p=0.003）。此外，慢性疼痛患病率下降60%（从81%降至21%，p<0.001）。与之相反，术后患者的外分泌与内分泌胰腺功能均出现恶化：糖尿病患病率、需接受胰岛素治疗及口服胰腺酶制剂的患者比例均显著升高。对40例（24%）完成完整影像学检查的患者进行身体成分分析后发现，术后其营养状态未出现显著变化。
讨论与结论 尽管在疼痛缓解方面取得了良好效果，但手术治疗仍会导致患者整体胰腺功能持续恶化。未发现手术对患者的营养状态存在显著影响。