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Enteral nutrition in pancreatitis

Katalin Márta, Nelli Farkas, Imre Szabó, Anita Illés, Áron Vincze, Gabriella Pár, Patrícia Sarlós, Judit Bajor, Ákos Szűcs, József Czimmer, Dóra Mosztbacher, Andrea Párniczky, Kata Szemes, Dániel Pécsi, Péter Hegyi
The recently published guidelines for acute pancreatitis (AP) suggest that enteral nutrition (EN) should be the primary therapy in patients suffering from severe acute pancreatitis (SAP); however, none of the guidelines have recommendations on mild and moderate AP (MAP). A meta-analysis was performed using the preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P). The following PICO (problem, intervention, comparison, outcome) was applied: P: nutrition in AP; I: enteral nutrition (EN); C: nil per os diet (NPO); and O: outcome...
October 20, 2016: International Journal of Molecular Sciences
Gregory C Jones, Christopher A R Sainsbury
Cystic fibrosis is a common genetic condition and abnormal glucose handling leading to cystic fibrosis-related diabetes (CFRD) is a frequent comorbidity. CFRD is mainly thought to be the result of progressive pancreatic damage resulting in beta cell dysfunction and loss of insulin secretion. Whilst Oral Glucose Tolerance Testing is still recommended for diagnosing CFRD, the relationship between glucose abnormalities and adverse outcomes in CF is complex and occurs at stages of dysglycaemia occurring prior to diagnosis of diabetes by World Health Organisation criteria...
October 17, 2016: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
Jing Zhou, Lu Ke, Dongliang Yang, Yizhe Chen, Gang Li, Zhihui Tong, Weiqin Li, Jieshou Li
BACKGROUND: Splanchnic venous thrombosis (SVT) is a relatively rare but important complication of necrotizing acute pancreatitis (NAP). Clinical manifestations and severity of this complication in different patients vary greatly, ranging from mild abdominal discomfort even asymptomatic to lethal gastrorrhagia or hepatic failure. The aim of the present study was to develop a model to predict the clinical manifestations of SVT in NAP patients. METHODS: This retrospective cohort study was conducted in the surgical intensive care unit (SICU) of Jinling Hospital...
October 3, 2016: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Andrius Karpavicius, Zilvinas Dambrauskas, Audrius Gradauskas, Arturas Samuilis, Kristina Zviniene, Juozas Kupcinskas, Gintautas Brimas, Artur Meckovski, Audrius Sileikis, Kestutis Strupas
BACKGROUND: Recent data shows that patients with severe acute pancreatic might benefit from early intensive therapy, enteral nutrition and timely transfer to specialized centers. The early prophylactic use of antibiotics in AP remains controversial. The role and need for new markers in stratification of acute pancreatitis is also uncertain. This study aims to evaluate the prognostic usefulness of adipokines in prediction of the severity and outcome of acute pancreatitis (AP). METHODS: Prospective study was conducted in four clinical centers...
2016: BMC Gastroenterology
Liang Ji, Jia-Chen Lv, Zeng-Fu Song, Mai-Tao Jiang, Le Li, Bei Sun
BACKGROUND: Severe acute pancreatitis (SAP) remains a clinical challenge with considerable morbidity and mortality. An early identification of infected pancreatic necrosis (IPN), a life-threatening evolution secondary to SAP, is obliged for a more preferable prognosis. Thus, the present study was conducted to identify the risk factors of IPN secondary to SAP. METHODS: The clinical data of patients with SAP were retrospectively analyzed. Univariate and multivariate logistic regression analyses were sequentially performed to assess the associations between the variables and the development of IPN secondary to SAP...
August 2016: Hepatobiliary & Pancreatic Diseases International: HBPD INT
Julie Perinel, Christophe Mariette, Bertrand Dousset, Igor Sielezneff, Alain Gainant, Jean-Yves Mabrut, Sylvie Bin-Dorel, Michel El Bechwaty, Dominique Delaunay, Lorraine Bernard, Alain Sauvanet, Marc Pocard, Emmanuel Buc, Mustapha Adham
OBJECTIVES: The aim of this study was to compare nasojejunal early enteral nutrition (NJEEN) with total parenteral nutrition (TPN), after pancreaticoduodenectomy (PD), in terms of postoperative complications. BACKGROUND: Current nutritional guidelines recommend the use of enteral over parenteral nutrition in patients undergoing gastrointestinal surgery. However, the NJEEN remains controversial in patients undergoing PD. METHODS: Multicenter, randomized, controlled trial was conducted between 2011 and 2014...
November 2016: Annals of Surgery
R D Zhuang, L J Tang, Y H Fang, K R Peng, J Chen
OBJECTIVE: To explore the efficacy and safety of the application of enteral nutrition (EN) in gastrointestinal disease in children, and to explore the possibility of the implementation of family EN. METHOD: Retrospective analysis of disease spectrum, EN approach, preparation, speed and time as well as adverse reactions and outcomes in 47 pediatric patients with gastrointestinal disease underwent EN therapy during July 2014 to March 2015. The nutrition indicators before and after EN therapy were compared by paired t-test...
July 2016: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Simone Gärtner, Janine Krüger, Ali A Aghdassi, Antje Steveling, Peter Simon, Markus M Lerch, Julia Mayerle
BACKGROUND: Pancreatic cancer is the fourth leading cause of cancer-related mortality in both genders. More than 80% of patients suffer from significant weight loss at diagnosis and over time develop severe cachexia. Early nutritional support is therefore essential. SUMMARY: This review evaluates the different nutritional therapies, such as enteral nutrition, parenteral nutrition and special nutritional supplements, on nutritional status, quality of life and survival...
May 2016: Gastrointestinal Tumors
Thilo Hackert, Markus Wolfgang Büchler
The management of acute necrotizing pancreatitis (ANP) has undergone a change of paradigms during the last 2 decades with a decreasing impact of surgical interventions. Modern ANP management is done conservatively as long as possible and therapeutic approaches aim at volume resuscitation, pain management and early enteral nutrition. The diagnostic gold standard of contrast-enhanced CT scan helps to evaluate the extent of necrosis of the pancreas, which correlates with the risk of tissue infection. The crucial point for decision making is the proven existence of infected pancreatic necrosis...
2016: Digestive Diseases
Jayshil J Patel, Martin D Rosenthal, Keith R Miller, Robert G Martindale
PURPOSE OF REVIEW: The purpose of this review is to describe established and emerging mechanisms of gut injury and dysfunction in trauma, describe emerging strategies to improve gut dysfunction, detail the effect of trauma on the gut microbiome, and describe the gut-brain connection in traumatic brain injury. RECENT FINDINGS: Newer data suggest intraluminal contents, pancreatic enzymes, and hepatobiliary factors disrupt the intestinal mucosal layer. These mechanisms serve to perpetuate the inflammatory response leading to multiple organ dysfunction syndrome (MODS)...
August 2016: Current Opinion in Critical Care
Lan Peng, Li-Guo Wu, Bo Li, Jun Zhao, Li-Ming Wen
PURPOSE: To investigate the role of early enteral nutrition (EEN) in the intestinal immune barrier in SAP, and to explore its potential mechanisms. METHODS: Sixty rats were randomly assigned to 3 groups: sham-operated group (SO group, n = 20), SAP group receiving EEN (SAP + EEN group, n = 20), and SAP group receiving total parental nutrition (SAP + TPN group, n = 20). SAP was induced by infusion of sodium taurocholate. Rats were sacrificed 5 days after nutritional support...
May 10, 2016: Journal of Hepato-biliary-pancreatic Sciences
Yo-Ichi Yamashita, Tomoharu Yoshizumi, Kengo Fukuzawa, Takashi Nishizaki, Eiji Tsujita, Kiyoshi Kajiyama, Yuji Soejima, Motoyuki Yamagata, Kazuharu Yamamoto, Eisuke Adachi, Keishi Sugimachi, Yasuharu Ikeda, Hideaki Uchiyama, Takashi Maeda, Shinji Itoh, Norifumi Harimoto, Toru Ikegami, Yoshihiko Maehara
BACKGROUND: Postoperative pancreatic fistula (POPF) remains a major complication after pancreaticoduodenectomy (PD), and the prognosis of patients with pancreatic ductal adenocarcinoma (PDAC) after PD is poor. PATIENTS AND METHODS: A multi-institutional retrospective study was performed in 174 patients who underwent PD for PDAC from 2007 to 2012. The details of clinical data were examined, and risk factors for POPF and poor prognostic factors after PD were identified...
May 2016: Anticancer Research
D Stimac, G Poropat, G Hauser, V Licul, N Franjic, P Valkovic Zujic, S Milic
BACKGROUND/OBJECTIVES: There is substantial evidence of superiority of enteral nutrition (EN) to parenteral nutrition in acute pancreatitis (AP) treatment, but few studies evaluated its effectiveness compared to no intervention. The objective of our trial was to compare the effects of EN to a nil-by-mouth (NBM) regimen in patients with AP. METHODS: Patients with AP were randomized to receive either EN via a nasojejunal tube initiated within 24 h of admission or no nutritional support...
July 2016: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Benoît Dupont, Marietta Musikas, Manh-Thông Dao, Marie-Astrid Piquet
No abstract text is available yet for this article.
May 2016: Pancreas
Dominique Turck, Christian P Braegger, Carla Colombo, Dimitri Declercq, Alison Morton, Ruzha Pancheva, Eddy Robberecht, Martin Stern, Birgitta Strandvik, Sue Wolfe, Stephane M Schneider, Michael Wilschanski
BACKGROUND: Malnutrition is both a frequent feature and a comorbidity of cystic fibrosis (CF), with nutritional status strongly associated with pulmonary function and survival. Nutritional management is therefore standard of care in CF patients. ESPEN, ESPGHAN and ECFS recommended guidelines to cover nutritional management of patients with CF. METHODS: The guidelines were developed by an international multidisciplinary working group in accordance with officially accepted standards...
June 2016: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Amer Hawatmeh, Anas Alkhateeb, Ahmad Abu Arqoub, Khalid Jumean, Hamid Shaaban
The percutaneous endoscopic gastrostomy (PEG) tube is an important method of providing enteral nutrition to patients with swallowing disorders and those who need long-term enteral nutritional support. The association between PEG tube migration and acute pancreatitis is rare and was previously described in the literature. To the best of our knowledge, only 11 cases have been reported in the literature. In this article, we are describing two cases of acute pancreatitis secondary to PEG tube balloon migration to the duodenum...
January 2016: International Journal of Critical Illness and Injury Science
Nagarajan Ramakrishnan, Bhuvaneshwari Shankar, Lakshmi Ranganathan, D K Daphnee, Adithya Bharadwaj, Ramesh Venkataraman
BACKGROUND: Enteral nutrition (EN) is preferred over parenteral nutrition (PN) in hospitalized patients based on International consensus guidelines. Practice patterns of PN in developing countries have not been documented. OBJECTIVES: To assess practice pattern and quality of PN support in a tertiary hospital setting in Chennai, India. METHODS: Retrospective record review of patients admitted between February 2010 and February 2012. RESULTS: About 351,008 patients were admitted to the hospital in the study period of whom 29,484 (8...
January 2016: Indian Journal of Critical Care Medicine
Amy Tyberg, Kunal Karia, Moamen Gabr, Amit Desai, Rushabh Doshi, Monica Gaidhane, Reem Z Sharaiha, Michel Kahaleh
Pancreatic fluid collections (PFCs) are a frequent complication of pancreatitis. It is important to classify PFCs to guide management. The revised Atlanta criteria classifies PFCs as acute or chronic, with chronic fluid collections subdivided into pseudocysts and walled-off pancreatic necrosis (WOPN). Establishing adequate nutritional support is an essential step in the management of PFCs. Early attempts at oral feeding can be trialed in patients with mild pancreatitis. Enteral feeding should be implemented in patients with moderate to severe pancreatitis...
February 21, 2016: World Journal of Gastroenterology: WJG
Giles Bond-Smith, Ajay P Belgaumkar, Brian R Davidson, Kurinchi Selvan Gurusamy
BACKGROUND: 'Fast-track surgery' or 'enhanced recovery protocol' or 'fast-track rehabilitation', incorporating one or more elements of preoperative education, pain relief, early mobilisation, enteral nutrition and growth factors, may improve health-related quality of life and reduce length of hospital stay and costs. The role of enhanced recovery protocols in major upper gastrointestinal, liver and pancreatic surgery is unclear. OBJECTIVES: To assess the benefits and harms of enhanced recovery protocols compared with standard care (or usual practice) in major upper gastrointestinal, liver and pancreatic surgery...
2016: Cochrane Database of Systematic Reviews
Piet J Lodewijkx, Marc G Besselink, Ben J Witteman, Nicolien J Schepers, Hein G Gooszen, Hjalmar C van Santvoort, Olaf J Bakker
Severe acute pancreatitis poses unique nutritional challenges. The optimal nutritional support in patients with severe acute pancreatitis has been a subject of debate for decades. This review provides a critical review of the available literature. According to current literature, enteral nutrition is superior to parenteral nutrition, although several limitations should be taken into account. The optimal route of enteral nutrition remains unclear, but normal or nasogastric tube feeding seems safe when tolerated...
2016: Expert Review of Gastroenterology & Hepatology
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