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Early refeeding after endoscopic biliary or pancreatic sphincterotomy: a randomized prospective study
M Barthet1, A Desjeux, M Gasmi
1Department of Gastroenterology, Hôpital Nord, Marseille, France. mbarthet@mail.ap-hm.fr
Endoscopy
|August 10, 2002
Summary
Early refeeding after endoscopic sphincterotomy (ES) significantly reduces abdominal pain and hospital stays. This study challenges the routine fasting protocol for patients undergoing ES, suggesting benefits for quicker recovery.
Area of Science:
- Gastroenterology
- Endoscopic Procedures
- Post-procedural Care
Background:
- Patients undergoing endoscopic sphincterotomy (ES) traditionally fast until the next day.
- The justification for this prolonged fasting period is often arbitrary.
Purpose of the Study:
- To evaluate the necessity and impact of routine fasting after ES.
- To determine if early refeeding is safe and beneficial for patients.
Main Methods:
- A blinded, randomized prospective study involving 146 patients undergoing ES.
- Patients were divided into two groups: early refeeding (4 hours post-ES) and delayed refeeding (24 hours post-ES).
- Clinical data and procedural details were compared between groups.
Main Results:
- Early refeeding (Group 1) led to significantly less abdominal pain (11% vs. 37%, P=0.01) and fewer patients requiring strong analgesics.
- Serum amylase and lipase levels increased post-refeeding in the early group but not significantly in the delayed group.
- The mean hospital stay was significantly shorter in the early refeeding group (2.6 days vs. 3.8 days, P=0.03).
Conclusions:
- Early refeeding after ES, in the absence of complications like perforation or severe pancreatitis, can decrease pain.
- Early refeeding is associated with a shorter hospital stay for patients undergoing ES.
- The study suggests that routine prolonged fasting post-ES may not be necessary.