ENTERAL FEEDING IN ACUTE PANCREATITIS TREATMENT

Abstract

Introduction. Improving of treatment results for acute pancreatitis treatment by the administration of early selective enteral feeding in proximal part of jejunum bypassing of duodenum and decreasing frequency of infectious complications. Material and methods. There was designed a method of multifactorial treatment of acute pancreatitis at the basis of original catheter. Isolating of duodenum at the area around the papilla Vateri. That is prevent trespassing of various gastrointestinal fluids throw this zone and serving selective infusion of liquids and enteral feeding in the proximal part of jejunum. The open label, randomized, prospective multicentral trial was conducted in 7 clinical cities from 6 cities of Russian Federation. Only moderate and severe forms of pancreatitis alimentary and biliary (without indications for endoscopic retrograde cholangiopancreatography) etiology were included. The second control group received a standard of care due to International and Russian guidelines. The patients of first group received a standard therapy with combination of novel method. Investigation included a 5 and final visits. The period of follow up was 3 months for detection of various infection complications and frequencies of surgical approaches. Results. In study 163 patients with moderate and severe forms of pancreatitis were recruited in trial, 31 (20.9%) excluded due to protocol violations. All patients were equally randomized in both groups by age, gender, and BMI. As a result, frequency of infectious complications decreasing from 19.3% to 6.67% (p=0.041). Surgical approaches decreased in first group to 5.0%, in second control group of SoC — 19.3% (p=0.017). Conclusion. The trial demonstrates that implementation of novel method of selective feeding except of duodenum at the beginning of acute pancreatitis play a critical role. Novel method improved a result of treatment and decreased several infectious complications and surgical approaches. The study demonstrates a safety and effectiveness that novel method of acute pancreatitis treatment.