title: Therapeutic effects of endoscopic therapy combined with enteral nutrition on acute severe biliary pancreatitis.
abstract: BACKGROUND
  Acute severe biliary pancreatitis (ASBP) is a severe and fatal disease, and the expenditure is huge and therapeutic effects are still not satisfactory. This study aimed to improve the therapeutic effects and reduce the expenditure of ASBP treatment.
  
  
  METHODS
  One hundred and five patients diagnosed with ASBP were referred to our department from January 2004 to July 2009. Diagnosis was based on the 2007 criteria of the Chinese Society of Surgery. Patients were divided into two groups; the E group: 50 patients who underwent endoscopic retrograde choledochopancreatography (ERCP) + endoscopic sphincterotomy (EST) + endoscopic lithotripsy basket (ESR) + endoscopic retrograde biliary drainage (ERBD) and enteral nutrition (EN), and the R group: 55 patients who underwent traditional treatment without ERCP. Subsequently, subjective symptoms, signs, biochemical analysis, serum endotoxin, tumor necrosis factor a, grades by computed tomography (CT), cost of hospitalization and length of stay were compared between the two groups.
  
  
  RESULTS
  All enrolled patients complied well with all therapeutic regimens. Endoscopic therapy that combined EN could significantly improve symptoms, clinical signs, laboratory values, tumor necrosis factor a and endotoxin while significantly reducing hospital expenditure and length of hospital stay. The experimental findings revealed that there were obvious advantages in the E group compared with the R group.
  
  
  CONCLUSIONS
  Endoscopic therapy combined with EN is an effective, safe and economic therapeutic regimen of ASBP.
authors: Department II of General Surgery, the First Hospital of Lanzhou University, the First Clinical Medical School of Lanzhou University, Lanzhou, Gansu 730000, China.
authors: Wen-Ce
authors: WC
authors: Zhou
authors: Yu-Min
authors: YM
authors: Li
authors: Hui
authors: H
authors: Zhang
authors: Xun
authors: X
authors: Li
authors: Lei
authors: L
authors: Zhang
authors: Wen-Bo
authors: WB
authors: Meng
authors: Ke-Xiang
authors: KX
authors: Zhu
authors: Quan-Bao
authors: QB
authors: Zhang
authors: Min-Yan
authors: MY
authors: He
mesh_terms: D000208:Acute Disease; D002760:Cholangiopancreatography, Endoscopic Retrograde; D004322:Drainage; D016145:Endoscopy, Digestive System; D004750:Enteral Nutrition; D005260:Female; D042882:Gallstones / Q000150:complications; D006801:Humans; D008096:Lithotripsy; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000209:etiology / Q000628:therapy*; D016717:Sphincterotomy, Endoscopic