Enteral nutrition in treatment of severe acute pancreatitis.

Objective: To observe the role and the timing of EN in the treatment of patients with severe acute pancreatitis (SAP).

Methods: Eleven patients with severe acute pancreatitis underwent systemic nutrition support were studied. EN was given through jejunostomy tube (or Bengmark tube) after a period of PN maintenance. EN started when serum and urine amylase activity returned to normal with regular peristaltic sound, defecation or break wind. The sequence of preparation was as follows: saline glucose-->chemically defined diet-->polymeric diet-->normal diet.

Results: In all the patients, none died. The rate of late complications was lower, and the levels of serum albumin and transferritin significantly increased in the post-EN period as compared with the pre-EN period, although the count of lymphocytes was less changed.

Conclusions: Nutritional support should be transformed from PN to EN as early as possible during the treatment of patients with severe acute pancreatitis. EN could not only continue sufficient nutritional support, but also avoid the unfavorable effects of long-time PN, thus reducing complications as well as mortality.