AIM:To evaluate the effect of early intrajejunal nutrition (EIN) on the natural course, entero-hormone secretion and its efficacy on dogs with acute pancreatitis. METHODS:An acute pancreatitis model was induced by injecting 1 ml/kg of combined solution (2.5 % sodium taurocholate and 8 000-10 000 BAEE units trypsin/ml) into the pancreas via pancreatic duct. Fifteen dogs were divided into parenteral nutrition (PN) group and EIN group. Two groups were isonitrogenous and isocaloric. EIN was used at postoperative 24 h. Serum glucose, calcium, amylase and lysosomal enzymes were determined before and 1, 4, 7 d after acute pancreatitis was induced. All the dogs were injected 50 uCi RESULTS:There was no difference between two groups in the contents of serum calcium, amylase and lysosomal enzymes, 125 I-BSA index of pancreas/muscle and pancreas/ blood and PPS. The contents of CCK and gastrin in EIN were higher than those in PN group at 60 and 120 min (P<0.05). The content of SEC post-infusion of nutrition solution was higher than that of pre-infusion of nutrition solution in both groups, and only at 60 min SEC in EIN group was higher than that in PN group. The content of gastrin in EIN was higher than that in PN group at 120 and 180 min (P<0.05). CONCLUSION: EIN does not stimulate entero-hormone and pancreatic juice secretion, and enzyme-protein synthesis and release. EIN has no effect on the natural course of acute pancreatitis.Qin HL, Su ZD, Hu LG, Ding ZX, Lin QT. Parenteral versus early intrajejunal nutrition: Effect on pancreatitic natural course, entero-hormones release and its efficacy on dogs with acute pancreatitis.
Qin HL, Su ZD, Hu LG, Ding ZX, Lin QT. Effect of parenteral and early intrajejunal nutrition on pancreatic digestive enzyme synthesis, storage and discharge in dog models of acute pancreatitis. World J Gastroenterol 2007; 13(7): 1123-1128http://www.wjgnet.com/1007-9327/13/1123.asp INTRODUCTIONBeneficial effects of total enteral nutrition (TEN) have been noted in a number of diseases, such as burn, trauma, and sepsis. In comparison with parenteral nutrition (PN), TEN can reduce nosocomial infection, multiple organ failure (MOF), and the length of hospitalization [1][2][3][4] . Early enteral nutritional (EEN) support in patients with acute pancreatitis (AP) has been evaluated by some authors who reported that it can moderate the acute phase response and improve disease severity and clinical outcome [5][6][7][8][9][10] . However, the commonly encountered problems of gastric atony and outlet obstruction have limited the successful delivery of enteral nutrition to patients with severe acute pancreatitis. In addition, many surgeons believe that EEN may lead to recurrence of symptoms and delayed complications, because EEN may increase the release of digestive enzymes and lysosomal hydrolases. This action of digestive enzymes and lysosomal hydrolases may be important in the development of acute pancreatitis, as lysosomal enzymes such as cathepsin B, are known to be capable of activating trypsinogen and intracellular digestive enzymes that may trigger the autodigestive phenomenon of the pancreas [11] . However, these problems may be overcome if enteral nutrition is delivered to the jejunum as distal as possible from Treitz's ligament, thereby avoiding stimulation of the cephalic and gastric phase. Therefore, it is necessary to investigate the effect of early intrajejunal nutrition (EIN) on pancreatic acinar cell uptake of 3 H phenylalanine, digestive enzyme synthesis, storage and discharge in dogs with AP. MATERIALS AND METHODS Materials Abstract AIM:To study the effect of early intrajejunal nutrition on enzyme-protein synthesis and secretion during acute pancreatitis. METHODS:Fifteen dogs were randomly divided into parenteral nutrition (n = 7) and early intrajejunal nutrition groups (n = 8). An acute pancreatitis model was induced by injecting 5% sodium taurocholate and trypsin into the pancreas via the pancreatic duct. Intrajejunal nutrition was delivered with a catheter via a jejunostomy t u b e a f t e r t h e m o d e l wa s e s t a b l i s h e d fo r 2 4 h . On d 1 and 7 and at the beginning of nutritional support, radioactive tracing and electron microscopes were used to evaluate the enzyme-protein synthesis in acinar cells, the subcellular fractionation and the change in zymogen granules after 1.85 × 10 6 Bq L-3 H phenylalanine was infused at 30, 60, 120, and 180 min. RESULTS:The 3 H radioactivity in pancreatic acinar cells reached its peak level at 60 min, and the contents in the early intrajejunal nutrition group were higher than those in the parenteral nutrition group, which were then decreased. The mean numbe...
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