News Release

Short-term hemofiltration is cost-effective for severe acute pancreatitis

Peer-Reviewed Publication

World Journal of Gastroenterology

Early nasogastric enteral nutrition is a breakthrough in the management of severe acute pancreatitis. From meta-analysis based on current available clinical studies early nasogastric enteral nutrition appeared effective and safe in clinical practice.

Three randomized controlled clinical trials were eligible, and 131 participants were included. Of them, 67 were randomly assigned to the early nasogastric enteral nutrition group and 64 to the conventional nutritional route group. Conventional routes included total parenteral nutrition and nasojejunal enteral nutrition.

Nutritional management of severe acute pancreatitis is regarded as an indispensable approach. Total parenteral nutrition and gastrointestinal tract rest have been recommended in the management of severe acute pancreatitis since the mid 1990s. Enteral nutrition through jejuna route has been accepted as a safe and effective approach to the management of severe acute pancreatitis by preserving the integrity of intestinal mucosa and preventing bacterial translocation. Some studies have attempted to assess the feasibility and safety of early enteral nutrition through nasogastric route.

Early nasogastric enteral nutrition is a breakthrough in the management of severe acute pancreatitis. Previously, it was forbidden because it might potentially oppose the requirement of pancreatic rest in the acute inflammation phase. However, the present systematic review of three randomized controlled trials showed that nasogastric route does not worsen the clinical outcomes compared with the conventional total parenteral or jejunal enteral routes.

Gastrointestinal and pancreatic rest has been regarded as an important factor for management of severe acute pancreatitis. Nevertheless, nasogastric enteral nutrition disobeys this discipline. Whether the nasogastric route is able to gain similar results to gastrointestinal and pancreatic rest needs to be further investigated. If possible, serological, radiological or histological appraisal should be considered for the effectiveness and safety of early nasogastric enteral nutrition in the treatment of severe acute pancreatitis.

Nasogastric route is much more convenient in clinical practice. Moreover, it is obviously cheaper than nasojejunal tube placement. Based on the present results, nasogastric enteral nutrition can be applied in the early management of severe acute pancreatitis. However, before its application in clinical practice, further investigation is necessary to validate its effectiveness and safety.

The research group evaluated the effectiveness and safety of early nasogastric enteral nutrition for severe acute pancreatitis compared with conventional nutritional routes. Based on current studies, early nasogastric enteral nutrition appears effective and safe, but the available evidence is limited.

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Reference: Jiang K, Chen XZ, Xia Q, Tang WF, Wang L.Early nasogastric enteral nutrition for severe acute pancreatitis: A systematic review. World J Gastroenterol 2007; 13(39): 5253-5260 http://www.wjgnet.com/1007-9327/13/5253.asp

Correspondence to: Professor Qing Xia, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China. xiaqing@medmail.com.cn Telephone: +86-28-85422557

About World Journal of Gastroenterology

World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection for providing a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2003-2000 IF: 3.318, 2.532, 1.445 and 0.993. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. The WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.

About The WJG Press

The WJG Press mainly publishes World Journal of Gastroenterology.


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