Early Enteral Feeding Versus Total Parenteral Feeding After Surgery in Severe Acute Pancreatitis: An Evidence-Based Case Report.

Abstract

Background: Acute pancreatitis is a self-limiting inflammatory disease that in some cases may lead to severe acute pancreatitis. To prevent this development, multimodal management, including nutritional management, is used in treating acute pancreatitis patients. The controversy between parenteral and enteral feeding has led to major debate. This case report aims to assess which method has better outcomes based on multiple cases of organ failure, inflammatory response, and length of hospital stay.

Methods: A 46-year-old male presented to the Emergency Department of our hospital with acute abdominal pain, nausea, and vomiting, 12 h before admission. Based on physical and further examination, the patient was diagnosed with severe acute pancreatitis and underwent a necrotomy procedure. Articles from multiple databases were obtained and assessed using the Cochrane Collaboration Risk of Bias tool. The articles were analyzed using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and a forest plot model. Effect size quantification for continuous and categorical variables was analyzed using continuous and binary random effect models, respectively.

Results: Seven articles were obtained after exclusion and review. A total of 491 patients with acute/severe acute pancreatitis were assessed. These seven articles conclude that enteral nutrition has advantages over parenteral nutrition.

Conclusion: Our study concluded that early enteral feeding provides better clinical improvement, reduced lipase enzyme levels, and shortened length of hospital stay.