Efficacy and safety of immediate oral intake in patients with mild acute pancreatitis: A randomized controlled trial

Horibe, Masayasu; Iwasaki, Eisuke; Nakagawa, Atsuo; Matsuzaki, Juntaro; Minami, Kazuhiro; Machida, Yujiro; Tamagawa, Hiroki; Takimoto, Yoichi; Ueda, Masahiro; Katayama, Tadashi; Kawasaki, Shintaro; Matsushita, Maiko; Seino, Takashi; Fukuhara, Seiichiro; Kanai, Takanori

doi:10.1016/j.nut.2020.110724

Cited by 17 publications

(62 citation statements)

References 32 publications

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“…Hence, immediate EN could significantly make LOHS shorter and relieve intolerance of feeding in the present study. Immediate oral feeding may suppress the progression of severe AP but the present meta analysis did not show meaningful result due to a low number of events and participants which was consistent with the three original studies (15,21,23). At present, some published meta-analyses explored the optimal time of EN in AP (19,(33)(34)(35)(36).…”

Section: Discussionsupporting

confidence: 78%

“…A total of 99 articles were captured from four electronic databases and one article was found by manual searching of references of all the included studies and related reviews. After initial selection and full-text selection, 5 studies involving 372 patients were included in the present study [ 15 , 21 , 22 , 23 , 30 ]. The flow diagram of searching and selecting of articles was displayed in Figure 1 .…”

Section: Resultsmentioning

confidence: 99%

“… Study ID Country AP NO. of Patients Age of Patients T/C (years) Drop out T/C Interventions Outcomes T (M/F) C (M/F) T C Eckerwall 2007 [ 15 ] Sweden mild 13/17 14/16 56(48–72)/ 52(38–60) 1/0 immediately allowed to drink and eat freely as tolerated firstly fasting and oral fluids and diet reintroduced in a traditional stepwise manner pancreas-specific amylase, CRP and leukocytes, Intolerance, LOHS Teich 2010 [ 21 ] Germany mild 42/27 51/23 (45.4 ± 1.6)/ (46.7 ± 1.8) 11/27 self-selected eating lipase level < 2-fold of ULM LOHS, Pain relief, Complications Yang 2018 [ 22 ] China mild 23/19 20/22 (44.38 ± 9.38)/ (44.69 ± 2.12) 0 immediately allowed to drink and eat freely drink and eat when bowel sounds are present and abdominal pain is relieved LOHS, Mortality rate, Intolerance, Complications Horibe 2020 [ 23 ] Japan mild 10/3 8/5 (50.1 ± 5.3)/ (60.8 ± 5.3) 0/1 immediate oral intake of low-fat (15 g/d) solid food a gradually increasing amount of dietary fat after a fast LOHS, Rehospitalization rate, Progression from mild to severe AP Esmer 2021 [ 31 ] Mexico mild 3/26 5/25 37(20–49)/ 38(18–89) 0 immediate oral feeding within 8 h early oral feeding within 48 h Intolerance, LOHS Abbreviations: AP: acute pancr...…”

Section: Resultsmentioning

confidence: 99%

“…Progression to severe pancreatitis There were three studies providing the specific information about progression to severe pancreatitis (15,21,23). The meta analysis of three studies involving 168 patients revealed that immediate EN didn't significantly increase the number of progression to severe pancreatitis compared with early refeeding(RR=0.76; 95%CI, 0.15-3.76; P=0.73; I 2 =11%; presented as Figure 5).…”

Section: Abdominal Painmentioning

confidence: 99%

“…Contrary to this, some recent studies stated that immediate EN seems to be a safe approach. Two RCTs demonstrated this way may accelerate recovery without increasing adverse gastrointestinal events [ 15 , 21 ]. However, this result was not observed in others [ 22 , 23 ].…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Immediate enteral nutrition can accelerate recovery and be safe in mild acute pancreatitis: A meta-analysis of randomized controlled trials

Guo

Tian

Qin

et al. 2022

Heliyon

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Han, W. Wang, Immediate enteral nutrition can accelerate recovery and be safe in mild acute pancreatitis: a meta-analysis of randomized controlled trials, HELIYON, https://doi.org/10.1016/j.heliyon.2022.e08852. This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Section: Discussionsupporting

confidence: 78%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Abdominal Painmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Immediate enteral nutrition can accelerate recovery and be safe in mild acute pancreatitis: A meta-analysis of randomized controlled trials

Guo

Tian

Qin

et al. 2022

Heliyon

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JPNclinical practice guidelines 2021 with easy‐to‐understand explanations for the management of acute pancreatitis

Takada

Isaji

Mayumi

et al. 2022

J Hepato Biliary Pancreat

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Background In preparing the Japanese (JPN) guidelines for the management of acute pancreatitis 2021, the committee focused the issues raised by the results of nationwide epidemiological survey in 2016 in Japan. Method In addition to a systematic search using the previous JPN guidelines, papers published from January 2014 to September 2019 were searched for the contents to be covered by the guidelines based on the concept of GRADE system. Results Thirty‐six clinical questions (CQ) were prepared in 15 subject areas. Based on the facts that patients diagnosed with severe disease by both Japanese prognostic factor score and contrast‐enhanced computed tomography (CT) grade had a high fatality rate and that little prognosis improvement after 2 weeks of disease onset was not obtained, we emphasized the importance of Pancreatitis Bundles, which were shown to be effective in improving prognosis, and the CQ sections for local pancreatic complications had been expanded to ensure adoption of a step‐up approach. Furthermore, on the facts that enteral nutrition for severe acute pancreatitis was not started early within 48 h of admission and that unnecessary prophylactic antibiotics was used in almost all cases, we emphasized early enteral nutrition in small amounts even if gastric feeding is used and no prophylactic antibiotics are administered in mild pancreatitis. Conclusion All the members of the committee have put a lot of effort into preparing the extensively revised guidelines in the hope that more people will have a common understanding and that better medical care will be spread.

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Impact of solid food provision within 24 hours of hospital admission on clinical outcomes for adult patients with acute pancreatitis: A literature review

2023

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Acute pancreatitis (AP) is a common gastrointestinal disease necessitating hospitalization, with incidence increasing both in the United States and worldwide. Some recent guidelines for hospitalized patients with AP recommend initiation of oral feeding within 24 h of admission; however, a lack of clarity regarding feeding time and diet orders in clinical practice still exists. This review presents recent randomized clinical trials regarding feeding administration for patients with mild to moderate AP. The results indicate that initiation of a low‐fat solid oral diet within 24 h of admission does not increase the instance of negative outcomes and may also provide positive benefits to patients with AP.

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Efficacy and safety of immediate oral intake in patients with mild acute pancreatitis: A randomized controlled trial

Cited by 17 publications

References 32 publications

Immediate enteral nutrition can accelerate recovery and be safe in mild acute pancreatitis: A meta-analysis of randomized controlled trials

Immediate enteral nutrition can accelerate recovery and be safe in mild acute pancreatitis: A meta-analysis of randomized controlled trials

JPNclinical practice guidelines 2021 with easy‐to‐understand explanations for the management of acute pancreatitis

Impact of solid food provision within 24 hours of hospital admission on clinical outcomes for adult patients with acute pancreatitis: A literature review

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