Role of individually staged nutritional support in the management of severe acute pancreatitis.
BACKGROUND
Severe acute pancreatitis (SAP) as a common acute abdomen due to complicated causes is characterized by lots of morbidities, difficult treatment, and high mortality. This study was designed to investigate the role of individually staged nutritional support (ISNS) in the treatment of SAP.


METHODS
One hundred patients with SAP admitted to our hospital from January 1997 to October 2002 were randomly divided into total parenteral nutrition group (TPN group, 50 patients) and individually staged nutrition group (individualized group, 50 patients), between which the therapeutic outcome and the incidence of complications were carefully analyzed.


RESULTS
Compared with the TPN group, the individualized group had less complications (62 vs 94 patients) including incubation related complications (2% vs 16%), superinfections (8% vs 30%), hepatic functional insufficiency (4% vs 24%) and intra-peritoneal infections (4% vs 12%), in addition to a sooner restoring of oral nutrition (18.5 vs 24.8 days, P<0.05), a shorter hospital stay (24.5 vs 30.2 days) and a lower hospital cost (4.1 vs 5.8 10,000 yuan, P<0.05).


CONCLUSIONS
ISNS, which provides SAP patients with sufficient energy and nutrients according to their true pathological status, is an ideal nutrition planning with lowered incidence of complications, shortened hospital stay and lightened financial burden.
Department of General Surgery, First Clinical Hospital, Harbin Medical University, Harbin 150001,China. sunbei70@tom.com
Bei
B
Sun
Yue
Y
Gao
Jun
J
Xu
Xiao-Lin
XL
Zhou
Zun-Qiang
ZQ
Zhou
Chang
C
Liu
Hong-Chi
HC
Jiang
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004750:Enteral Nutrition / Q000009:adverse effects; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000178:diet therapy*; D010289:Parenteral Nutrition, Total / Q000009:adverse effects; D012720:Severity of Illness Index; D016896:Treatment Outcome