Patients after acute pancreatitis benefit from long-term home enteral nutrition

Background

Stimulation of exocrine pancreatic function by oral intake impairs resolving of necrotic peripancreatic masses after severe acute pancreatitis. A long-term parenteral or enteral nutrition may be beneficial in the therapy of postpancreatitic complications. Aim of the study was to verify efficacy and safety of long-term home enteral nutrition for therapy of pancreatic pseudocysts after severe acute pancreatitis.

Patients and methods

Eighty-nine patients with severe acute pancreatitis were evaluated in the prospective clinical study: females 38, males 51, mean age 53.2 years (18-80). After initial period of total parenteral nutrition (TPN) and early enteral nutrition (EEN) with mean duration 13.2 days (5-23), patients were matched into two groups with either enteral or oral nutrition, matching in Ranson's score, age, and size of peripancreatic pseudocysts. Fifty-nine patients (enteral group) were administered an enteral oligopeptide formula, 30 patients (oral group) were administered a pancreatic diet. Criteria of effectiveness of home enteral nutrition were disappearance or substantial regression of the peripancreatic necrotic masses. The results were compared between both groups and evaluated by the paired Student's t-test.

Results

A significant regression of pseudocysts was reached in 65 patients (73.0%) overall: in 48 (81.4%) patients in the group treated with enteral nutrition, and in 17 (50.9%) patients with oral intake. The difference was statistically significant (P < 0.01). Number of severe complications within the enteral group was 1 (1.7%). Mean period of enteral nutrition was 28.9 days, mean period of controlled oral diet was 27.4 days (n.s.).

Conclusions

The results indicate that the long-term home enteral nutrition was a potent method in the therapy of pancreatic pseudocysts and it was superior to oral diet. Its effectiveness is similar with total parenteral nutrition, which has been tested in our previous study [1].