title: Meta-analysis of parenteral nutrition versus enteral nutrition in patients with acute pancreatitis.
abstract: OBJECTIVE
  To compare the safety and clinical outcomes of enteral and parenteral nutrition in patients with acute pancreatitis.
  
  
  METHODS
  Medline, Embase, Cochrane controlled trials register, and citation review of relevant primary and review articles.
  
  
  METHODS
  Randomised controlled studies that compared enteral nutrition with parenteral nutrition in patients with acute pancreatitis. From 117 articles screened, six were identified as randomised controlled trials and were included for data extraction.
  
  
  METHODS
  Six studies with 263 participants were analysed. Descriptive and outcome data were extracted. Main outcome measures were infections, complications other than infections, operative interventions, length of hospital stay, and mortality. The meta-analysis was performed with the random effects model.
  
  
  RESULTS
  Enteral nutrition was associated with a significantly lower incidence of infections (relative risk 0.45; 95% confidence interval 0.26 to 0.78, P = 0.004), reduced surgical interventions to control pancreatitis (0.48, 0.22 to 1.0, P = 0.05), and a reduced length of hospital stay (mean reduction 2.9 days, 1.6 days to 4.3 days, P < 0.001). There were no significant differences in mortality (relative risk 0.66, 0.32 to 1.37, P = 0.3) or non-infectious complications (0.61, 0.31 to 1.22, P = 0.16) between the two groups of patients.
  
  
  CONCLUSIONS
  Enteral nutrition should be the preferred route of nutritional support in patients with acute pancreatitis.
authors.affiliation: Department of Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15261, USA. maripe@ccm.upmc.edu
authors.forename: Paul E
authors.initials: PE
authors.lastname: Marik
authors.forename: Gary P
authors.initials: GP
authors.lastname: Zaloga
mesh_terms: D000208:Acute Disease; D003141:Communicable Diseases / Q000209:etiology; D004750:Enteral Nutrition / Q000379:methods*; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D010195:Pancreatitis / Q000150:complications / Q000401:mortality / Q000628:therapy*; D010288:Parenteral Nutrition / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome