Effects of Early Jejunum Nutrition on the Comprehensive Therapy for Severe Acute Pancreatitis

Background: Nutrition supporting therapy is one of the important aspects of the integrated treatment for patients with severe acute pancreatitis (SAP). The modality and method of nutritional support play a key role on improving the general status, preventing the intestinal failure, alleviating systemic inflammatory syndrome as well as improving the prognosis of patients with SAP. Aims: To appraise the effects of early jejunum nutrition on the course of illness, the general condition and prognosis of the patients with SAP. Methods: Thirty-eight patients with SAP were randomly divided into two groups: enteral nutrition (EN) group and total parenteral nutrition (TPN) group. Eighteen patients in EN group were emplaced jejunum nutrition tube through gastroendoscope and administered jejunal essential diet supporting therapy in the early stage of SAP (3～5 days after onset); twenty patients in the TPN group received total parenteral nutrition therapy. Before and after the treatment, blood cell count, blood glucose, liver function test, renal function test, serum albumin and prealbumin as well as abdominal ultrasonic examination, CT or magnetic resonance imaging (MRI) were performed to evaluate the pancreatic lesions. Results: The liver function and renal function test, and blood white cell count (WBC) were of no significant difference between the two groups before treatment. Two to three weeks after treatment, the recovery of WBC to normal in EN group was significantly shorter than that in TPN group (P0.01). After treatment, the serum albumin and prealbumin levels in EN group increased significantly (P0.01 and P0.001) and were higher than those in TPN group (P0.01 and P0.001). The incidence of complications, such as infection rate and mortality in EN group were lower than those in TPN group, but of no significant difference (P0.05). Conclusions: Early jejunum nutrition supporting therapy can promote albumin synthesis and elevate the serum albumin and prealbumin levels in patients with SAP, and may lower the incidence of complications and improve its prognosis.