Abstract
Severe acute pancreatitis (SAP) leads to numerous inflammatory and nutritional disturbances. All SAP patients are at a high nutritional risk. It has been proven that proper nutrition significantly reduces mortality rate and the incidence of the infectious complications in SAP patients. According to the literature, early (started within 24–48 h) enteral nutrition (EN) is optimal in most patients. EN protects gut barrier function because it decreases gastrointestinal dysmotility secondary to pancreatic inflammation. Currently, the role of parenteral nutrition (PN) in SAP patients is limited to patients in whom EN is not possible or contraindicated. Early versus delayed EN, nasogastric versus nasojejunal tube for EN, EN versus PN in SAP patients and the role of immunonutrition (IN) in SAP patients are discussed in this review.
Highlights
According to the current mentioned above theory of “no pancreatic rest”, the nasogastric tube (NGT) might be preferred in severe acute pancreatitis (SAP) patients, because it has been proven that insertion of the feeding tube in the stomach does not increase pancreatic secretion in SAP patients, and theoretically gastric placement of the feeding tube is easier
We found a study on the association between a polymeric formula in enteral nutrition (EEN) and chylous ascites (CA) in SAP patients
It is certain and indisputable that nutritional support is necessary in all SAP patients in order to improve the nutritional status as well as to modulate an altered immune response, prevent the gut barrier dysfunction, bacterial translocation and infectious complications
Summary
Acute pancreatitis (AP) is an inflammatory disease involving a pancreatic parenchyma and peripancreatic tissues with a potential systematic immune response in a severe disorder course. The incidence of AP has increased in most countries. The mean global AP incidence is 34/100,000 [1]. The incidence of AP in Europe ranges from 4.6 to 100/100,000 [2]. Poland is one of the countries with the highest incidence rate—72.1/100,000 [3]
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