Nasogastric suction in alcoholic pancreatitis

Abstract

In order to assess the usefulness of nasogastric suction in acute alcoholic pancreatitis, 37 patients with alcoholic pancreatitis were prospectively investigated. The study failed to demonstrate efficacy of nasogastric suction in those patients with mild disease. Application of a system of prognostic signs proved useful in discriminating between mild and severe disease. Routine use of ultrasound examinations detected three pancreatic pseudocysts before they became clinically apparent. In instituting appropriate therapy in mild pancreatitis, factors such as patient comfort should be considered in the absence of proven significant value of nasogastric suction.

Experimental pancreatitis is mediated by low-affinity cholecystokinin receptors that inhibit digestive enzyme secretion.

“…More convincing data implicating excessive secretion as a cause of pancreatitis, however, have not been reported. Attempts to treat clinical pancreatitis by reducing the stimulus for pancreatic secretion by gastric drainage (21) or administration of agents such as glucagon (22) or H2 histamine receptor antagonists (23) have not been noted to favorably affect the course of the disease. Our observations using the caerulein and CDE diet-induced models of pancreatitis may redirect thinking in this area since they suggest that some forms of inhibition of secretion might contribute to the development of pancreatitis rather than to its treatment.…”

Comparison of Fasting, Nasogastric Suction and Cimetidine in the Treatment of Acute Pancreatitis

“…The fact that in this and previous studies [2,[10][11][12] avoiding NG suction was not detrimental to the course of AP suggests that either gastric acidity has little influence on pancreatic secretion, or whatever secre tory stimulus basal gastric acid can have is of no importance in an acutely inflamed pan creas.…”

“…That NG suction is no better than fasting alone in the treatment of mild to moderate AP has previously been reported in alcoholic [2,10] or mostly alcoholic [11,12] patients. The present work confirms this observation and extends to patients with AP of any etiol ogy.…”

“…In four trials in volving mostly patients with alcoholic pan creatitis [2,[10][11][12], fasting alone and NG suction were shown to have similar thera peutic effects.…”

Influence of Secretin on the Course of Acute Experimental Pancreatitis in Rats

“…However, experimental and clinical studies on the effect of different measures aiming at direct or indirect inhibi tion of pancreatic secretion, including gastric suction [9,10,17,20], cimetidine [7, 22. 26], atropine [2], glucagon [4,16,19] and calci tonin [11.…”