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[Digestive refeeding in acute pancreatitis. When and how?]
K Papapietro1, M Marin, E Díaz
1Unidad de Nutrición Intensiva, Departamento de Cirugía y Centro de Gastroenterología Hospital Clínico de la Universidad de Chile.
Revista Medica De Chile
|June 21, 2001
Summary
Early digestive refeeding in acute pancreatitis is safe using clinical criteria, even with CT scan evidence of necrosis or fluid collections. This approach avoids prolonged fasting and complications, with oral feeding as a viable first option.
Area of Science:
- Gastroenterology
- Clinical Nutrition
- Medical Imaging
Background:
- Digestive refeeding in acute pancreatitis presents challenges, including resolving intestinal ileus and preventing pancreatitis reactivation.
- Prolonged fasting is often employed, but optimal refeeding strategies require further evaluation.
Purpose of the Study:
- To establish criteria for early digestive refeeding in acute pancreatitis patients.
- To avoid unnecessary prolonged fasting periods and associated risks.
Main Methods:
- A prospective trial involving 30 acute pancreatitis patients.
- Severity assessed using APACHE II score and Balthazar CT scan classification.
- Refeeding criteria: absence of nausea/vomiting, reduced pain, bowel sounds, and decreased serum amylase.
Main Results:
- 80% of patients showed CT scan alterations (Balthazar stages C, D, E).
- Early refeeding (oral or enteral) was initiated between 4-19 days post-diagnosis.
- No instances of pancreatitis reactivation were observed in the study cohort.
Conclusions:
- The proposed clinical criteria enable safe digestive refeeding in acute pancreatitis.
- Pancreatic necrosis or fluid collections do not contraindicate refeeding.
- Oral feeding can be the initial approach in selected patients without increasing complication risk.