Early versus On-Demand Nasoenteric Tube Feeding in Acute Pancreatitis

In this trial in patients with acute pancreatitis, early tube feeding was not superior to an oral diet after 72 hours (with tube feeding if needed) in reducing the rate of major infection or death. In the oral-diet group, 69% of patients did not require tube feeding. Acute pancreatitis is the most common gastrointestinal disease leading to hospital admission, and its incidence continues to rise. 1 – 4 Most patients with acute pancreatitis recover uneventfully and are discharged after a few days. 5 , 6 In 20% of patients, the disease course is complicated by major infection, such as infected pancreatic necrosis, which is associated with a mortality of 15%. 7 – 11 A meta-analysis of eight randomized trials involving 348 patients showed that nasoenteric tube feeding, as compared with total parenteral nutrition, reduced the rate of infections and mortality among patients with severe pancreatitis. 12 These infections are thought to be mediated by . . .