Abstract
Objective. To estimate the efficacy of early enteral nutrition (EEN) in patients with an acute complicated pancreatitis, after determining of its content and improving the realization methods.
 Маterials and methods. There were studied the results of EEN in 82 patients, suffering an acute complicated pancreatitis. Two groups of patients were delineated - the main (n=58), in which EEN was included into the complex of treatment in preoperative and postoperative periods, and a comparative one (n=24). For conduction of EEN the probe was put during fibrogastroscopy into jejunum (in 25 patients), while suboperative nasogastrointestinal intubation was performed (in 12), and a jejunostomy in accordance to Witzel procedure was formatted (in 21), what have appeared the most effective procedure and served for realization of the Fast track surgery principles.
 Results. Nutritious food blends were applied in combination with probiotics and the metabolism correctors. Application of EEN in the patients іn an acute complicated pancreatitis have promoted more rapid restoration of a motor-evacuation function of a small bowel, normalization of levels of the blood leukocytes and proteins, weakening of microstructural changes in mucosa and «clearance» of purulent-necrotic focus.
 Conclusion. EEN in the patients, suffering an acute complicated pancreatitis constitutes an effective component of surgical treatment in preoperative and postoperative periods.
Highlights
Despite the fact that early EEF is a well–known component of treatment programs for acute complicated pancreatitis (ACP), a number of questions regarding the use of this method remains unclear [1 – 3]
Materials and methods EEF results were studied when used in a sample group of 82 patients with diagnosed ACP, who were on inpatient treatment in the City Pancreatic Centre at the Academic Department of General Surgery of the Danylo Halytsky National Medical University
EEF was performed in accordance with the European Society for Parenteral and Enteral Nutrition recommendations (ESPEN, 2009) and implemented in accordance with the developed composition and sequence of components use, which included the primary intraluminal drip infusion with NaCl physiological and hypertonic solutions, followed by the administration of officinal calorage–balanced nutritional mixtures at the first signs of peristalsis recovery, as well as Saccharomyces boulardii probiotic (I–745) 250 mg in order to normalize obligate gut flora and levelling excessive colonization of the proximal small intestine with pathogenic microflora
Summary
Despite the fact that early EEF is a well–known component of treatment programs for acute complicated pancreatitis (ACP), a number of questions regarding the use of this method remains unclear [1 – 3]. This concerns, in particular, the approach to its implementation method, the choice of nutritional mixtures for adequate nutritional support, effect evaluation on the recovery of digestive tract motor–evacuation function and levelling manifestations of enteral insufficiency [4, 5]. The feasibility of using EEF in ACP requires further scientific–theoretical and practical–applied study
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