Enteral nutrition in treatment of severe acute pancreatitis.
OBJECTIVE
To observe the role and the timing of EN in the treatment of patients with severe acute pancreatitis (SAP).


METHODS
Eleven patients with severe acute pancreatitis underwent systemic nutrition support were studied. EN was given through jejunostomy tube (or Bengmark tube) after a period of PN maintenance. EN started when serum and urine amylase activity returned to normal with regular peristaltic sound, defecation or break wind. The sequence of preparation was as follows: saline glucose-->chemically defined diet-->polymeric diet-->normal diet.


RESULTS
In all the patients, none died. The rate of late complications was lower, and the levels of serum albumin and transferritin significantly increased in the post-EN period as compared with the pre-EN period, although the count of lymphocytes was less changed.


CONCLUSIONS
Nutritional support should be transformed from PN to EN as early as possible during the treatment of patients with severe acute pancreatitis. EN could not only continue sufficient nutritional support, but also avoid the unfavorable effects of long-time PN, thus reducing complications as well as mortality.
Shi
Dun
D
Department of General Surgery, Zhejiang Provincial People's Hospital, Hangzhou 310014, China. sdsyd@mail.hz.zj.cn
Zhang
Cheng-Wu
CW
Jiang
Jin-Song
JS
Xie
Zhi-Jie
ZJ
Zou
Shou-Chun
SC
D000208:Acute Disease; D000328:Adult; D000368:Aged; D004750:Enteral Nutrition; D005260:Female; D006801:Humans; D007582:Jejunostomy; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000178:diet therapy*; D011379:Prognosis; D012709:Serum Albumin; D012720:Severity of Illness Index; D014168:Transferrin / Q000378:metabolism
D012709:Serum Albumin; D014168:Transferrin