Evidence-based use of enteral nutrition in acute pancreatitis

Attila Oláh, László Romics

Research output: Contribution to journalReview article

22 Citations (Scopus)

Abstract

Purpose A systematic review was carried out to analyze current evidence-based data on the use of enteral nutrition in the management of acute pancreatitis. Methods Literature search was performed on "Pubmed" and "Medline" databases to identify articles investigating the role and potential effect of enteral nutrition on the outcome of patients with acute pancreatitis. Relevant data were analyzed from the viewpoints of possible benefits and complications, route and timing of administration, and composition of nutrients. Results Thirty-two prospective randomized controlled trials and 15 meta-analyses of those were identified and included in this overview. Strong evidence suggests that enteral nutrition significantly reduces mortality rate of severe acute pancreatitis. While both nasogastric and nasojejunal feeding appear to be safe in severe pancreatitis, early low-fat oral diet is possibly beneficial in patients with mild pancreatitis. Since maintenance of the gut barrier function is one of the crucial effects of enteral nutrition, enteral feeding should be commenced within the first 24 h after hospital admission, in order to prevent early bacterial translocation. However, it seems that neither immunonoenhanced nutrients nor probiotic supplementation are able to reduce mortality further, and-therefore-cannot be recommended for patients with acute pancreatitis. Conclusion Although enteral nutrition is undoubtedly a key component of the management of acute pancreatitis, the exact role of that is needed to be defined yet. In particular, conflicting data from studies on nutrient compositions will require further clarification in the future.

Original languageEnglish
Pages (from-to)309-316
Number of pages8
JournalLangenbeck's Archives of Surgery
Volume395
Issue number4
DOIs
Publication statusPublished - Apr 1 2010

Keywords

  • Acute pancreatitis
  • Bacterial translocation
  • Enteral nutrition
  • Immunonutrition

ASJC Scopus subject areas

  • Surgery

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