PD360 - BODY COMPOSITION IN WALLED-OFF PANCREATIC NECROSIS: A SINGLE-CENTRE RETROSPECTIVE EXPERIENCE

PD360

BODY COMPOSITION IN WALLED-OFF PANCREATIC NECROSIS: A SINGLE-CENTRE RETROSPECTIVE EXPERIENCE

L. Horváth^1,*, L. Havelda², P. J. Hegyi¹

¹Institute of Pancreatic Diseases, ²Department of Dietetics and Nutritional Science, Semmelweis University, Budapest, Hungary

Rationale: Walled-off pancreatic necrosis (WOPN) is an encapsulated collection occurring in up to 15% of severe acute pancreatitis (AP) cases. Our study analyzed body composition and nutritional status in 64 WOPN patients (treated May 2022–Nov 2025) using tools available at our institute.

Methods: We conducted a retrospective analysis on 64 patients categorized by treatment: Endoscopic Ultrasound-guided Lumen-Apposing Metal Stent (LAMS) (n=42) vs. conservative management (n=22). Parameters included BMI, Bioelectrical Impedance Analysis (BIA), hand-grip strength (dynamometry), and the Malnutrition Universal Screening Tool (MUST).

Results: Of 64 patients, 41 (64.1%) were male (66.7% LAMS; 59.1% conservative) with a median age of 54.5 years. BIA was performed in 21 LAMS (50%) and 12 conservative (54%) patients. Mean ECW ratios (0.396 vs. 0.388) were elevated in 67% of LAMS and 50% of conservative cases; these fluid collections distorted muscle parameters (FFMI, SMI), making BIA unreliable for WOPN.Hand-grip strength was assessed in 11 LAMS patients: 82% had weak grip and 18% normal values. Among 16 conservatively treated patients, 31% had weak, 44% normal, and 25% strong grip strength. MUST scores showed worse nutritional status in the LAMS group (n=32): 41% low, 13% moderate, 47% high risk; in the conservative group (n=21), 76% were low, 10% moderate, and 14% high risk. Overall, LAMS patients had poorer general condition, weaker muscle strength, and higher malnutrition risk, likely related to longer hospitalization and reduced feeding.

Conclusion: WOPN patients, particularly those requiring LAMS, are at significant risk for malnutrition and sarcopenia. Because fluid collections compromise BIA accuracy, CT-based body composition assessment is recommended as a more reliable alternative. Management requires a multidisciplinary approach and further randomized studies to optimize nutritional care.

Disclosure of Interest: None declared