Meta-analysis: Nutritional Support In Severe Acute Pancreatitis

Objective: To perform a systematic review of the data from randomized controlled trials (RCT) in severe acute pancreatitis that compares enteral nutrition (EN) w i t h parenteral nutrition (PN).Methods: Pubmed, western biomedical databases, chinese biomedical database, CNKI, VIP database were searched from the beginning to december 2009 and the references of eligible studies were manually seeked. RCT comparing efficacy and safety in patients with severe acute pancreatitis who received early enteral nutrition with who received parenteral nutrition. The use of statistical software Revman 4.2 included in the study results on the heterogeneity test (P value), and using a fixed effects model and random effect model to merge research and draw bias funnel plot discussion.Results: Eight trials with a total of 326 participants were included. Comparing EN to PN for severe acute pancreatitis incidence of complications, the odds risk (OR) for systemic infection was 0.29 (95% CI 0.11 to 0.77), for multiple organ failure (MOF) was 0.38 (95%CI 0.20 to 0.72), for mortality was 0.33 (95%CI 0.14 to 0.78). Mean length of hospital stay was reduced by -2.43 days in EN vs PN groups (95% CI -8.39 to3.53).Conclusion: In patients with SAP, EN significantly reduced mortality, MOF, and systemic infections compared to those who received PN. These data suggested that EN should be considered the standard of care in patients with severe acute pancreatitis requiring nutritional support.