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.