Clinical Pancreatology for Practising Gastroenterologists and Surgeons. Группа авторов
BB, Bergenzaun PE, et al. Immediate oral feeding in patients with mild acute pancreatitis is safe and may accelerate recovery: a randomized clinical study. Clin Nutr 2007; 26:758–763.
28 28 Moraes JM, Felga GE, Chebli LA, et al. A full solid diet as the initial meal in mild acute pancreatitis is safe and results in a shorter length of hospitalization: results from a prospective, randomized, controlled, double‐blind clinical trial. J Clin Gastroenterol 2010; 44:517–522.
29 29 Bevan MG, Asrani VM, Bharmal S, et al. Incidence and predictors of oral feeding intolerance in acute pancreatitis: a systematic review, meta‐analysis, and meta‐regression. Clin Nutr 2017; 36:722–729.
30 30 Bevan MG, Asrani V, Petrov MS. The oral refeeding trilemma of acute pancreatitis: what, when and who? Expert Rev Gastroenterol Hepatol 2015; 9:1305–1312.
31 31 Pupelis G, Plaudis H, Zeiza K, et al. Oral feeding in necrotizing pancreatitis. Acta Chir Belg 2014; 114:34–39.
32 32 Pendharkar SA, Plank LD, Windsor JA, et al. Quality of life in a randomized trial of nasogastric tube feeding in acute pancreatitis. JPEN J Parenter Enteral Nutr 2016; 40:693–698.
33 33 Sun JK, Mu XW, Li WQ, et al. Effects of early enteral nutrition on immune function of severe acute pancreatitis patients. World J Gastroenterol 2013; 19:917–922.
34 34 Yokoe M, Takada T, Mayumi T, et al. Japanese guidelines for the management of acute pancreatitis: Japanese Guidelines 2015. J Hepatobiliary Pancreat Sci 2015; 22:405–432.
35 35 Vivian E, Cler L, Conwell D, et al. Acute Pancreatitis Task Force on Quality: development of quality indicators for acute pancreatitis management. Am J Gastroenterol 2019; 114:1322–1342.
36 36 Crockett SD, Wani S, Gardner TB, et al. American Gastroenterological Association Institute guideline on initial management of acute pancreatitis. Gastroenterology 2018; 154:1096–1101.
37 37 Eatock FC, Brombacher GD, Steven A, et al. Nasogastric feeding in severe acute pancreatitis may be practical and safe. Int J Pancreatol 2000; 28:23–29.
38 38 Eatock FC, Chong P, Menezes N, et al. A randomized study of early nasogastric versus nasojejunal feeding in severe acute pancreatitis. Am J Gastroenterol 2005; 100:432–439.
39 39 Kumar A, Singh N, Prakash S, et al. Early enteral nutrition in severe acute pancreatitis: a prospective randomized controlled trial comparing nasojejunal and nasogastric routes. J Clin Gastroenterol 2006; 40:431–434.
40 40 Chang YS, Fu HQ, Xiao YM, et al. Nasogastric or nasojejunal feeding in predicted severe acute pancreatitis: a meta‐analysis. Crit Care 2013; 17:R118.
41 41 Greenberg JA, Hsu J, Bawazeer M, et al. Clinical practice guideline: management of acute pancreatitis. Can J Surg 2016; 59:128–140.
42 42 Meier R, Ockenga J, Pertkiewicz M, et al. ESPEN guidelines on enteral nutrition: pancreas. Clin Nutr 2006; 25:275–284.
43 43 Mirtallo JM, Forbes A, McClave SA, et al. International consensus guidelines for nutrition therapy in pancreatitis. JPEN J Parenter Enteral Nutr 2012; 36:284–291.
44 44 Italian Association for the Study of the Pancreas, Pezzilli R, Zerbi A, Campra D, et al. Consensus guidelines on severe acute pancreatitis. Dig Liver Dis 2015; 47:532–543.
45 45 Petrov MS, Loveday BP, Pylypchuk RD, et al. Systematic review and meta‐analysis of enteral nutrition formulations in acute pancreatitis. Br J Surg 2009; 96:1243–1252.
46 46 Petrov MS, Atduev VA, Zagainov VE. Advanced enteral therapy in acute pancreatitis: is there a room for immunonutrition? A meta‐analysis. Int J Surg 2008; 6:119–124.
47 47 Poropat G, Giljaca V, Hauser G, et al. Enteral nutrition formulations for acute pancreatitis. Cochrane Database Syst Rev 2015;(3):CD010605.
48 48 Besselink MG, van Santvoort HC, Buskens E, et al. Probiotic prophylaxis in predicted severe acute pancreatitis: a randomised, double‐blind, placebo‐controlled trial. Lancet 2008; 371(9613):651–659.
49 49 Lherm T, Monet C, Nougiere B, et al. Seven cases of fungemia with Saccharomyces boulardii in critically ill patients. Intensive Care Med 2002; 28:797–801.
50 50 Tiengou LE, Gloro R, Pouzoulet J, et al. Semi‐elemental formula or polymeric formula: is there a better choice for enteral nutrition in acute pancreatitis? Randomized comparative study. JPEN J Parenter Enteral Nutr 2006; 30:1–5.
51 51 Endo A, Shiraishi A, Fushimi K, et al. Comparative effectiveness of elemental formula in the early enteral nutrition management of acute pancreatitis: a retrospective cohort study. Ann Intensive Care 2018; 8:69.
52 52 McClave SA, Taylor BE, Martindale RG, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (ASPEN). JPEN J Parenter Enteral Nutr 2016; 40:159–211.
53 53 Cassim MM, Allardyce DB. Pancreatic secretion in response to jejunal feeding of elemental diet. Ann Surg 1974; 180:228–231.
54 54 Grant JP, Davey‐McCrae J, Snyder PJ. Effect of enteral nutrition on human pancreatic secretions. JPEN J Parenter Enteral Nutr 1987; 11:302–304.
55 55 McArdle AH, Echave W, Brown RA, et al. Effect of elemental diet on pancreatic secretion. Am J Surg 1974; 128:690–692.
56 56 Neviackas JA, Kerstein MD. Pancreatic enzyme response with an elemental diet. Surg Gynecol Obstet 1976; 142:71–74.
57 57Ragins H, Levenson SM, Signer R, et al. Intrajejunal administration of an elemental diet at neutral pH avoids pancreatic stimulation. Studies in dog and man. Am J Surg 1973; 126:606–614.
58 58Stabile BE, Borzatta M, Stubbs RS, et al. Intravenous mixed amino acids and fats do not stimulate exocrine pancreatic secretion. Am J Physiol 1984; 246:G274–G280.
59 59Vison N, Hecketsweiler P, Butel J, et al. Effect of continuous jejunal perfusion of elemental and complex nutritional solutions on pancreatic enzyme secretion in human subjects. Gut 1978; 19:194–198.
11 Oral Refeeding in Acute Pancreatitis : When and How Should it be Restarted?
José Lariño‐Noia and Daniel de la Iglesia‐García
Department of Gastroenterology and Hepatology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
Introduction
Traditionally, refeeding in acute pancreatitis (AP) has been initiated when serum levels of pancreatic enzymes are decreasing, intestinal peristalsis is present, and patients are free from abdominal pain and fever. Oral intake has usually been started with clear liquids followed by solid low‐fat meals with increasing caloric content over a period of three to six days in order to minimize pancreatic stimulation and the risk for abdominal pain and AP relapse [1]. A concern that refeeding will lead to cholecystokinin release, stimulation of exocrine pancreatic secretion, and aggravation of pancreatitis has been the theoretical basis of the traditional “nil by mouth” management in the early phase of AP. However, this concept has been challenged in a number of recently published studies investigating either the optimal time for refeeding [2,3] or the optimal schedule [4–7].
Recent guidelines and technical reviews have recommended early oral feeding in mild (interstitial) AP [8–10]. In patients with predicted severe or necrotizing AP, hospital stay is typically prolonged, and patients are often intolerant to oral feeding for a longer period of time. In these latter groups of patients, establishing a definite diagnosis of severe or necrotizing AP usually occurs between three and five days after initial presentation, a time when nasogastric or nasojejunal feeding is recommended to maintain the gut‐mucosal barrier and to prevent infection of necrosis.
In this chapter, the following points are addressed: what is the optimal timing of oral refeeding in AP, how must the reintroduction of oral intake be scheduled,