Abstract:

【Abstract】 Objective  To compare the nutritional effects for patients with severe acute pancreatitis (SAP) by conventional nasoenteric feed tube placement plus gastroprokinetic agent, nasojejunal feeding tube placement guided by endoscopic or radiological assistance. Methods  A total of 45 SAP patients were included and divided into three groups by giving different tube placement described above(n=15 for each group). The three groups were compared pertaining to the success rate of tube insertion, incidence of complications, degree of comfort before, intra-and post-insertion of the feeding tube(VAS scoring) and average retention time of the tube. Results  There was no statistical difference among the three groups regarding the success rate of tube insertion, incidences of immediate and long-term complications(including nasopharyngeal bleeding, gastrointestinal bleeding, perforation, aspiration and dyspnea; pharyngitis, sinusitis, tube displacement and pulmonary infection) and average time of tube retention. However, insertion of the tube by conventional technique had lower VAS scoring and fewer complications than endoscopic or radiological assistance (P<0.05). Conclusion  Conventional nasoenteric feed tube placement and nasojejunal feeding tube placement with endoscopic or radiological assistance can be safe and reliable for patients with severe acute pancreatitis. Yet conventional tube placement should be prioritized, for it has fewer complications and favors to nutritional support and recovery, whereas endoscope-guided insertion of the feed tube is recommended for SAP patients required mechanical ventilation and continuous hemofiltration or complicated with pancreatic encephalopathy or duodenal stenosis.

Key words: Severe acute pancreatitis, Nasoenteric tube, Nasointestonal nutrition, Effect evaluation