Optimal timing of oral refeeding in mild acute pancreatitis: results of an open randomized multicenter trial.
OBJECTIVE
The aim of this study was to compare 2 protocols regarding the initiation of oral nutrition in patients with mild acute pancreatitis.


METHODS
We randomized 143 patients to the Lipase directed (LIP) (n = 74) and the self selected PAT (n = 69) group. In the (PAT) group, the patients restarted eating through self-selection. In the LIP group, serum lipase had to normalize before eating.


RESULTS
The mean time between admission and oral nutrition was 2 days (interquartile range [IQR], 1-3) in the PAT group and 3 days (IQR, 2-4) in the LIP group (P < 0.005). Before and after the first meal, the mean Δ visual analogue scale (VAS) was +3.14 mm (±11.5 mm) in the PAT group and +2.85 mm (±16.4) in the LIP group (P = 0.597). The length of hospital stay was 7 days (median; IQR, 5-10.5) in the PAT group and 8 days (median; IQR, 5.75-12) in the LIP group (P = 0.315).


CONCLUSIONS
We were not able to demonstrate a difference in postprandial abdominal pain or in the length of hospital stay. Patients with self-selected eating, however, were able to restart eating 1 day earlier, and this difference was found to be significant. Our data suggest that normalization of serum lipase is not obligatory for enteral nutrition in mild acute pancreatitis.
Teich
Niels
N
Internistische Gemeinschaftspraxis für Verdauungs- und Stoffwechselkrankheiten, Leipzig. teich@igvs.de
Aghdassi
Ali
A
Fischer
Julia
J
Walz
Bastian
B
Caca
Karel
K
Wallochny
Thomas
T
von Aretin
Andreas
A
von Boyen
Georg
G
Göpel
Siri
S
Ockenga
Johann
J
Leodolter
Andreas
A
Rüddel
Jessica
J
Weber
Eckhard
E
Mayerle
Julia
J
Lerch
Markus M
MM
Mössner
Joachim
J
Schiefke
Ingolf
I
D000208:Acute Disease; D000328:Adult; D002097:C-Reactive Protein / Q000032:analysis; D004435:Eating; D005260:Female; D006801:Humans; D007902:Length of Stay; D008049:Lipase / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010195:Pancreatitis / Q000201:enzymology / Q000628:therapy*; D012907:Smoking; D013997:Time Factors
D002097:C-Reactive Protein; D008049:Lipase