Risk Analysis of Pancreatitis With Pancreatolithiasis in Relation to Dyslipidemia as a Cofactor.

Background Pancreatic duct stones are a frequent structural complication of chronic pancreatitis and may contribute to recurrent attacks and progressive pancreatic damage. Dyslipidemia is associated with metabolic dysfunction and may influence the clinical course of pancreatic disease. However, the relationship between dyslipidemia and clinical outcomes among patients with chronic pancreatitis complicated by pancreatic duct stones remains incompletely defined. This study evaluated the association between dyslipidemia and clinical characteristics and short-term outcomes in these patients. Methodology This prospective observational study was conducted in the Department of Surgery, Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh, over a 24-month period from January 2021 to December 2022 and included 73 adults with established chronic pancreatitis and radiologically confirmed pancreatic duct stones. Patients with acute pancreatitis without established chronic pancreatic disease, alcohol-induced pancreatitis, gallstone pancreatitis, pancreatic malignancy, and other predefined exclusion criteria were excluded. Dyslipidemia was defined as the presence of at least one abnormal lipid parameter: triglycerides >150 mg/dL, total cholesterol >200 mg/dL, low-density lipoprotein cholesterol >130 mg/dL, or high-density lipoprotein cholesterol <40 mg/dL in men and <50 mg/dL in women. Patients were categorized into dyslipidemia (n = 47) and non-dyslipidemia (n = 26) groups. Clinical characteristics, pancreatitis severity, pancreatic duct stone characteristics, length of hospital stay, and 30-day clinical outcomes were compared between the two groups. Results The mean age of the study population was 46.8 ± 12.5 years, and 55 (75.3%) patients were male. Patients with dyslipidemia had a higher mean body mass index than those without dyslipidemia (26.7 ± 3.9 vs. 24.2 ± 3.4 kg/m², p = 0.006). Recurrent pancreatitis occurred in 30/47 (63.8%) patients with dyslipidemia compared with 9/26 (34.6%) without dyslipidemia (p = 0.017). Moderate-to-severe pancreatitis was more frequent in the dyslipidemia group (27/47 (57.4%) vs. 7/26 (26.9%), p = 0.012). Patients with dyslipidemia also had a greater mean number of previous pancreatitis episodes (3.2 ± 1.4 vs. 1.8 ± 0.9, p < 0.001) and a longer hospital stay (8.6 ± 3.4 vs. 5.2 ± 2.1 days, p < 0.001). No statistically significant association was observed between dyslipidemia and multiple pancreatic duct stones or stone diameter >5 mm. Conclusions In this prospective observational cohort of patients with chronic pancreatitis and pancreatic duct stones, dyslipidemia was associated with recurrent pancreatitis, greater previous attack frequency, moderate-to-severe pancreatitis, and prolonged hospitalization. These findings indicate a clinically relevant association between dyslipidemia and disease burden; however, they do not establish causality or an independent predictive effect. Reverse causality and residual confounding cannot be excluded. Larger multicenter studies with longer follow-up are needed to clarify the temporal and causal relationship between dyslipidemia and the progression of chronic pancreatitis.