[Jejunal feeding in necrotizing pancreatitis or after esophagectomy]

Has early jejunal glutamine-rich diet any advantage in the treatment of patients suffering from acute pancreatitis and after oesophagectomy? Eleven patients suffering from necrotizing pancreatitis and 23 patients operated on radically for esophageal cancer were fed intra jejunally with glutamine-rich Stresson Multi Fibre diet. Eight patients with necrotising pancreatitis and 13 oesophagectomy patients were fed with glutamine-poor Nutrition Multi Fibre. Nutritional status, serum proteins, acute phase proteins, immune-globulins, complement components (C3, C4), the ratio of subsets of peripheral lymphocytes were analysed on the 1st, 2nd, 4th and 10th days. Serum protein parameters were measured by laser nephelometry. CD cell surface antigen expression was measured with flow cytofluorometry, activity of phagocytes with whole blood chemiluminescences. Laboratory parameters showed an improvement during the 10-day-treatment in both diet types, but significant improvement could be measured only in patients with necrotizing pancreatitis and fed with Stresson Multi Fibre: IgG (p < 0.05), serum protein (p < 0.02), prealbumin (p < 0.05), retinol binding protein (p < 0.03). The different diets did not cause difference in the laboratory results of the oesophagectomy patients. Early immune-enhancing diet improved serum proteins, acute phase proteins and immunoglobulins significantly in necrotizing pancreatitis. The length of hospital stay also decreased.