Although endoscopic and medical therapies effectively address the morphological and physiologic (exocrine and endocrine) sequelae of pancreatic disease (1), broader functional domains, such as nutrition, persistent pain, and psychosocial well-being are infrequently measured or integrated into routine care. This shortfall reflects procedure-centred clinical workflows that favour treatable structural targets, a lack of routinely collected, standardized metrics for functional domains, and fragmented or under-resourced multidisciplinary pathways worldwide. We aimed to characterize health-related quality of life (HRQoL) measures in a cohort undergoing endoscopic management for pancreatic disease.

We prospectively included patients from the St. Michael’s Hospital (Toronto) Pancreatic Disease Clinic undergoing endoscopic management of CP between April and November 2025. Eligible patients had one or more of the following: CP, severe recurrent pancreatic pain, obstructive pancreatic duct disease (stenosis or intraductal stones with ≥5 mm proximal dilation), a genetic/familial or autoimmune predisposition, or a history of necrotizing or recurrent acute pancreatitis. HRQoL was measured using the SF-36 (eight domains plus a total score). Participants completed baseline (pre-procedure) assessments and were reassessed at a median of 3 months after the endoscopic procedure. Within-subject changes from baseline to 3 months were evaluated by paired analyses, with paired mean differences reported alongside 95% confidence intervals. SF-36 domain scores were compared with established Canadian population norms (2). 

Fifty-two patients were included (28 female, 24 male); aetiologies were idiopathic 76.9%, genetic 7.7%, alcohol 3.8%, biliary 1.9%, hypertriglyceridemia 1.9% and other 7.7%. Twenty-nine patients underwent endoscopic management (diagnostic EUS 72.4%, EUS guided drainage 3.5%, FCSEMS 3.5%, pancreatic stenting 3.45%, ERCP stone clearance 13.8%, EUS celiac plexus block 10.3%). Overall SF-36 total score was 61.4 ± 19.7 at baseline and 62.5 ± 20.0 at 3 months (population 79.3 ± 22.3), an absolute mean change of +1.0 [−4.5 to 6.6] (baseline −17.9 vs population; 3 months −16.8 vs population). The three most prominent domain findings were: Social Functioning 51.5 ± 8.6 → 52.8 ± 8.0 (population 86.2 ± 19.8), change +1.3 [−2.9 to 5.4] (baseline −34.7 vs population; 3 months −33.4 vs population); General Health 48.9 ± 18.8 → 48.3 ± 19.2 (population 77.0 ± 17.7), change −0.6 [−5.3 to 4.2] (baseline −28.1 vs population; 3 months −28.7 vs population); and Physical Functioning 69.3 ± 34.2 (n=49) → 75.9 ± 28.8 (population 85.8 ± 20.0), change +6.6 [−2.6 to 15.7] (baseline −16.5 vs population; 3 months −9.9 vs population). Other domains showed small shifts: Role limitations due to Physical Health 74.5 ± 52.4 (n=50) → 79.6 ± 48.1, change +5.1 [−7.9 to 18.2]; Role limitations due to Emotional Health 67.3 ± 43.9 (n=50) → 66.7 ± 46.2, change −0.7 [−14.0 to 12.6]; Bodily Pain 65.9 ± 28.6 → 65.7 ± 32.7, change −0.3 [−8.8 to 8.3]; Vitality 49.4 ± 21.7 → 50.9 ± 18.8, change +1.6 [−3.7 to 6.8]; and Mental Health 64.7 ± 24.3 → 64.1 ± 23.8, change −0.7 [−6.8 to 5.5].

Despite endoscopic management, patients entered care with substantially reduced HRQoL and—apart from a small, non-significant improvement in physical functioning at 3 months—most domains (especially social functioning and general health) remained far below population norms. These results show that treating anatomical and physiological problems alone is insufficient: routine HRQoL measurement and integrated, multidisciplinary care (nutrition, pain/rehabilitation, psychology/social work and allied-health support) are needed to restore patients toward population-level wellbeing.