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Immediate feeding tolerance in patients with mild acute biliary pancreatitis
David Esmer1, Oscar Rivera-Villalobos1, Juan F Hernández-Sierra1
1Hospital Central "Ignacio Morones Prieto", Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México.
Antecedentes:
La pancreatitis aguda leve es una inflamación local del páncreas sin complicaciones locales ni falla orgánica. Su manejo consiste en tres elementos básicos: hidratación, analgesia y ayuno. La realimentación se inicia cuando el paciente no tiene dolor y refiere apetito, pero el momento exacto para iniciarla no está previamente documentado.
Objetivo:
Determinar la tolerancia a la alimentación oral inmediata (8 horas posterior al inicio del manejo) en comparación con la alimentación temprana (48 horas) en los pacientes con pancreatitis aguda biliar leve.
MéTodo:
Se incluyeron pacientes con pancreatitis aguda biliar leve y se aleatorizaron en dos grupos: A) alimentación temprana a las 48 horas (30 pacientes) y B) alimentación inmediata a las 8 horas de inicio del manejo (29 pacientes). Fueron evaluados por un tercer observador ciego (no involucrado en el estudio) para documentar síntomas como náusea, vómito, reactivación del dolor abdominal, síndrome de respuesta inflamatoria sistémica, tolerancia alimentaria y estancia hospitalaria.
Resultados:
No se encontraron diferencias significativas entre los grupos en cuanto a datos clínicos y bioquímicos. La estancia hospitalaria disminuyó significativamente en el grupo B (5.4 vs. 7.8 días; p < 0.003).
ConclusióN:
La alimentación inmediata en las primeras 8 horas del manejo de los pacientes con pancreatitis aguda biliar leve es bien tolerada y segura, y reduce la estancia hospitalaria.
Background:
Mild acute pancreatitis is defined as pancreatic edema, without organic failure and without local complications. Its management consists in three basic elements: hydration, analgesia and fasting. Start refeeding when the patient haven´t pain and referring hungry, but exact time for this is not previously documented.
Objective:
To determine the tolerance to immediate oral feeding (8 hours after the start of management) compared to early feeding (48 hours) in patients with mild acute biliary pancreatitis.
Method:
Included all patient with mild acute biliary pancreatitis, and they were randomized in to two groups: A) early oral feeding (n = 30) and B) immediate oral feeding (n = 29). They were evaluated by a third blind observer (not involved in the study) for documented symptoms like nausea, vomiting, reactivation of abdominal pain, systemic inflammatory response syndrome, food tolerance and hospital stay.
Results:
There were no significant differences between both groups in the clinical data or in the biochemical studies. The hospital stay was significantly less in the group B (5.4 vs. 7.8 days; p < 0.003).
Conclusion:
Immediate oral feeding is well tolerated and secure in patients with mild acute biliary pancreatitis.
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