Parenteral nutrition versus enteral nutrition in severe acute pancreatitis.
OBJECTIVE
To compare the effect of parenteral versus enteral nutritional support in severe acute pancreatitis, with respect to efficacy, safety, morbidity, mortality and length of hospitalization.


METHODS
The study was comprised of 31 patients, divided into a parenteral group (n=16) and an enteral group (n=15), who met severity criteria for abdominal tomography (Balthazar classes C, D, and E). The patients were compared by demographics, disease etiology, antibiotic prophylaxis, use or not of somatostatin, nutritional support, complications and disease progression.


RESULTS
There was no statistical difference in the average duration of nutritional support, somatostatin, or antibiotics in the two groups. Imipenem was the drug of choice for prophylaxis of pancreatic infections in both groups. More complications occurred in the parenteral group, although the difference was not statistically significant (p=0.10). Infectious complications, such as catheter sepsis and infections of the pancreatic tissue, were significantly more frequent in the parenteral group (p=0.006). There was no difference in average length of hospitalization in the two groups. There were three deaths in the parenteral group and none in the enteral group.


CONCLUSIONS
Enteral nutritional support is associated with fewer septic complications compared to parenteral nutritional support.
Vieira
Josiel Paiva
JP
Surgical Department, Federal University of Maranhao, Brazil. josielpv@hotmail.com
Araújo
Gutemberg Fernandes de
GF
Azevedo
José Raimundo Araújo de
JR
Goldenberg
Alberto
A
Linhares
Marcelo Moura
MM
D000208:Acute Disease; D004750:Enteral Nutrition / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000628:therapy*; D010288:Parenteral Nutrition / Q000009:adverse effects / Q000401:mortality