Abstract Objective To investigate the impact of timing of nasojejunal feeding tube placement and enteralnutrition on clinical outcomes in children with acute pancreatitis. Methods A retrospective analysis was performedon the clinical data of 31 children with acute pancreatitis, who received nasojejunal feeding between January 2008 andJuly 2013, to investigate the relationship of abdominal symptoms/signs and serum amylase level with the tolerabilityof catheterization and success rate of enteral nutrition. The treatment outcome and incidence of adverse reactions andcomplications were compared between the early enteral nutrition group (≤7 days from the onset of the disease) and lateenteral nutrition group (>7 days from the onset of the disease). Results Abdominal symptoms/signs and serum amylaselevel were independent of the tolerable rate of catheterization and success rate of enteral nutrition. Compared withthe late enteral nutrition group, the early enteral nutrition group had a shortened time to normal serum amylase level,significantly reduced incidence of systemic complications, length of hospital stay, and hospitalization expenses, and lessweight gain. The tolerable rate of catheterization and success rate of enteral nutrition showed no significant differencebetween the two groups. Similarly, no significant differences were found in the increase in albumin level after enteralnutrition, duration of enteral nutrition, incidence of adverse reactions, and incidence of local complications. Conclusions Abdominal symptoms/signs and serum amylase level cannot be used as a measure of whether nasojejunal feeding tubeplacement and enteral nutrition can be performed. Early enteral nutrition can better improve clinical outcomes in childrenwith acute pancreatitis, and it is feasible.
ZHUANG Rui-Dan,MA Ming,LOU Jin-Gan et al. Timing of nasojejunal feeding tube placement and enteral nutrition in children withacute pancreatitis[J]. CJCP, 2014, 16(11): 1086-1090.
ZHUANG Rui-Dan,MA Ming,LOU Jin-Gan et al. Timing of nasojejunal feeding tube placement and enteral nutrition in children withacute pancreatitis[J]. CJCP, 2014, 16(11): 1086-1090.
Wereszczynska-Siemiatkowska U, Swidnicka-Siergiejko A,Siemiatkowski A, et al. Early enteral nutrition is superior to delayed enteral nutrition for the prevention of infected necrosis and mortality in acutepancreatitis[J]. Pancreas, 2013, 42(4):640-646.
[2]
Gunilla E, Eckerwall BSN, Jakob B, et al. Early nasogastric feeding in predicted severe acute pancreatitis:a clinical, randomized study[J]. Ann Surg, 2006, 244(6):959-965.
Pezzilli R, Fantini L, Morselli-Labate AM, et al. New approaches for the treatment of acute pancreatitis[J]. Ospedali Italiani Chirurgia, 2004, 10:314-323.
Capurso G, Zerboni G, Signoretti M, et al. Role of the gut barrier in acute pancreatitis[J]. J Clin Gastroenterol, 2012, 46:46-51.
[7]
Sun JK, Mu XW, Li WQ, et al. Effects of early enteral nutrition on immune function of severe acute pancreatitis patients[J]. World J Gastroenterol, 2013, 19(6):917-922.
[8]
Li JY, Yu T, Chen GC, Yuan YH, et al. Enteral nutrition within 48 hours of admission improves clinical outcomes of acute pancreatitis by reducing complications:a meta-analysis[J]. PLoS One, 2013, 8(6):e64926.
[9]
Petrov MS, Windsor JA. Nutritional management of acute pancreatitis:the concept of 'gut rousing[J]. Curr Opin Clin Nutr Metab Care, 2013, 16(5):557-563.
[10]
Nakad A, Piessevaux H, Marot JC, et al. Is early enteral nutrition in acute pancreatitis dangerous? About 20 patients fed by an endoscopically placed nasogastrojejunal tube[J]. Pancreas, 1998, 17(2):187-193.
[11]
Li JY, Yu T, Chen GC, et al. Enteral nutrition within 48 hours of admission improves clinical outcomes of acute pancreatitis by reducing complications:a meta-analysis[J]. PLoS One, 2013, 8(6):e64926.
[12]
Windsor AC, Kanwar S, Li AG, et al. Compared with parenteral nutrition, enteral feeding attenuates the acute phase response and improves disease severity in acute pancreatitis[J]. Gut, 1998, 42(3):431-435.
[13]
Guillou PJ. Enteral versus parenteral nutrition in acute pancreatitis[J]. Baillieres Best Pract Res Clin Gastroenterol, 1999, 13(2):345-355.
[14]
De-Madaria E. Latest advances in acute pancreatitis[J]. Gastroenterol Hepatol, 2013, 36(2):98-102.
[15]
Banks PA1, Bollen TL, Dervenis C, et al. Classification of acute pancreatitis-2012:revision of the Atlanta classification and definitions by international consensus[J]. Gut, 2013, 62(1):102-111.
