Meta-analysis of the effectiveness of parenteral nutrition and enteral nutrition in acute pancreatitis

doi:10.3877/cma.j.issn.1674-0793.2011.05.016

Abstract

Abstract:

Objective

To analyze the effects of total parenteral nutrition (TPN) and enteral nutri- tion (EN) in patients with acute pancreatitis.

Methods

Electronic databases from January 1966 to March 2011 about randomized controlled trial of nutrition therapy in patients with acute pancreatitis were enrolled and Meta-analysis of these randomized controlled trial was used, the measurement index were morbidity, infection rate, multiple organ failure (MOF) rate, surgery intervention rate and length of stay.

Results

A total of 13 trials was included. Compared with conventional parenteral nutrition, morbidity of enteral nutrition in patients with acute pancreatitis reduced by 61% (95% CI = 24%~63%, P = 0.0001) , and infection rate reduced by 45% (95% CI = 38%~79%, P < 0.01) , and the multiple organ failure reduced by 69% (95% CI = 20%~48%, P < 0.01) , and the surgery intervention reduced by 73% (95% CI = 18%~42%, P < 0.01) . However, there was no statistically significant about the length of stay between EN and PN.

Conclusions

In patients with acute pancreatitis, enteral nutrition significantly reduced mortality, infections, multiple organ failure and surgery intervention compared to those who received TPN. This data suggests that EN should be considered the better way for patients with acute pancreatitis requiring nutritional support.

Key words: Meta-analysis, Acute pancreatitis, Enteral nutrition, Parenteral nutrition

Chun-ling XIE, Zhi-cheng HU, Bin ZHU, Bing TANG, Dong GUO, Bin CHEN, Kai ZHANG, Xiao-hui LI. Meta-analysis of the effectiveness of parenteral nutrition and enteral nutrition in acute pancreatitis[J]. Chinese Archives of General Surgery(Electronic Edition), 2011, 05(05): 425-431.

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References 30

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第一作者	年份	国家	肠内营养
第一作者	年份	国家	患者数（例）	住院时间（d）	死亡数（例）	感染数（例）	多器官功能衰竭数（例）	手术介入数（例）
Abou-Assi^[6]	2002	USA	26	14.20 ± 13.83	8	1	7	1
Casas^[7]	2007	Spain	11	30.20 ± 32.00	0	3	0	1
Gupta^[9]	2003	UK	8	7	0	1	0	0
Louie^[8]	2004	Canada	10	-	0	1	7	14
Doley^[10]	2009	India	25	42	5	16	5	-
Petrov^[11]	2006	Russia	35	-	2	11	10	5
Windsor^[12]	1998	UK	16	12.5	0	0	0	1
McClave^[13]	1997	USA	16	9.70 ± 7.35	0	4	0	0
Eckerwall^[14]	2006	Sweden	24	7	1	3	2	1
Olah^[15]	2002	Hungary	41	-	2	5	2	8
Kalfarentzos^[16]	1997	Greece	18	40.00 ± 17.20	1	5	1	2
Vieira^[17]	2010	Brazil	15	25.47 ± 5.55	0	2	0	4
Wu^[18]	2010	China	53	-	6	12	8	12
第一作者	年份	国家	肠外营养
第一作者	年份	国家	患者数（例）	住院时间（d）	死亡数（例）	感染数（例）	多器官功能衰竭数（例）	手术介入数（例）
Abou-Assi^[6]	2002	USA	27	18.40 ± 13.83	6	9	0	8
Casas^[7]	2007	Spain	11	30.70 ± 23.50	2	6	5	2
Gupta^[9]	2003	UK	9	10	0	2	3	4
Louie^[8]	2004	Canada	18	-	3	7	15	13
Doley^[10]	2009	India	25	36	4	15	-	3
Petrov^[11]	2006	Russia	34	-	12	27	11	23
Windsor^[12]	1998	UK	18	15	2	3	4	5
McClave^[13]	1997	USA	16	11.90 ± 14.70	0	5	0	0
Eckerwall^[14]	2006	Sweden	26	9	0	0	2	2
Olah^[15]	2002	Hungary	48	-	4	13	25	5
Kalfarentzos^[16]	1997	Greece	20	39.00 ± 17.34	2	10	4	2
Vieira^[17]	2010	Brazil	16	22.25 ± 11.07	3	4	4	1
Wu^[18]	2010	China	54	-	23	39	43	35

第一作者	年份	国家	肠内营养
第一作者	年份	国家	患者数（例）	住院时间（d）	死亡数（例）	感染数（例）	多器官功能衰竭数（例）	手术介入数（例）
Abou-Assi^[6]	2002	USA	26	14.20 ± 13.83	8	1	7	1
Casas^[7]	2007	Spain	11	30.20 ± 32.00	0	3	0	1
Gupta^[9]	2003	UK	8	7	0	1	0	0
Louie^[8]	2004	Canada	10	-	0	1	7	14
Doley^[10]	2009	India	25	42	5	16	5	-
Petrov^[11]	2006	Russia	35	-	2	11	10	5
Windsor^[12]	1998	UK	16	12.5	0	0	0	1
McClave^[13]	1997	USA	16	9.70 ± 7.35	0	4	0	0
Eckerwall^[14]	2006	Sweden	24	7	1	3	2	1
Olah^[15]	2002	Hungary	41	-	2	5	2	8
Kalfarentzos^[16]	1997	Greece	18	40.00 ± 17.20	1	5	1	2
Vieira^[17]	2010	Brazil	15	25.47 ± 5.55	0	2	0	4
Wu^[18]	2010	China	53	-	6	12	8	12
第一作者	年份	国家	肠外营养
第一作者	年份	国家	患者数（例）	住院时间（d）	死亡数（例）	感染数（例）	多器官功能衰竭数（例）	手术介入数（例）
Abou-Assi^[6]	2002	USA	27	18.40 ± 13.83	6	9	0	8
Casas^[7]	2007	Spain	11	30.70 ± 23.50	2	6	5	2
Gupta^[9]	2003	UK	9	10	0	2	3	4
Louie^[8]	2004	Canada	18	-	3	7	15	13
Doley^[10]	2009	India	25	36	4	15	-	3
Petrov^[11]	2006	Russia	34	-	12	27	11	23
Windsor^[12]	1998	UK	18	15	2	3	4	5
McClave^[13]	1997	USA	16	11.90 ± 14.70	0	5	0	0
Eckerwall^[14]	2006	Sweden	26	9	0	0	2	2
Olah^[15]	2002	Hungary	48	-	4	13	25	5
Kalfarentzos^[16]	1997	Greece	20	39.00 ± 17.34	2	10	4	2
Vieira^[17]	2010	Brazil	16	22.25 ± 11.07	3	4	4	1
Wu^[18]	2010	China	54	-	23	39	43	35

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