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The Visceral-to-subcutaneous Adipose Tissue Area Ratio Is Associated with Retreatment in Chronic Pancreatitis Patients with Pancreatolithiasis after Extracorporeal Shock Wave Lithotripsy
Authors:Kunihiko Yokoyama  Masaaki Takamura  Jun Watanabe  Atsuo Nakamura  Yuichi Sato  Atsuo Sekine  Shuji Terai
Affiliation:1.Division of Gastroenterology and Hepatology, Niigata University Graduate School of Medical and Dental Science, Japan; 2.Department of Gastroenterology, JA Niigata Kouseiren Nagaoka Chuo General Hospital, Japan; 3.Department of Internal Medicine, Niigata Prefectural Yoshida Hospital, Japan
Abstract:Objective Extracorporeal shock wave lithotripsy (ESWL) has been used to treat pancreatolithiasis in patients with chronic pancreatitis (CP), but the high recurrence rate remains challenging. We therefore evaluated the association between body composition parameters and the prediction of retreatment after ESWL. Methods This study retrospectively evaluated 42 patients with CP who had been treated with ESWL between 2008 and 2019 in a single center. Body composition parameters were measured on pretreatment computed tomography images. Patients who underwent repeat ESWL were classified as the retreatment group. Results There were 13 (31.0%) and 29 (69.0%) patients in the retreatment and non-retreatment groups, respectively. The visceral-to-subcutaneous adipose tissue area ratio (VSR) of the retreatment group was significantly lower than that of the non-retreatment group (p=0.016). When divided by the median VSR, 10 of the 20 patients with a VSR of <0.85 underwent retreatment, whereas 3 of the 22 patients with a VSR of ≥0.85 underwent retreatment (p=0.019). According to a multivariate analysis, the VSR (p=0.010) and age (p=0.037) were independent factors associated with retreatment after ESWL. Conclusion This study showed that the VSR can predict the retreatment of patients with CP after ESWL.
Keywords:body composition   chronic pancreatitis   pancreatolithiasis   extracorporeal shock wave lithotripsy   skeletal muscle
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