ESPEN Guidelines on Enteral Nutrition: Pancreas

Meier, Rémy; Ockenga, Johann; Pertkiewicz, M.; Pap, Ákos; Milinic, N.; MacFie, John; Löser, Christian; Keim, Volker

doi:10.1016/j.clnu.2006.01.019

Cited by 252 publications

(194 citation statements)

References 63 publications

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“…A number of recommendations for the diagnosis and treatment of chronic pancreatitis have been published in different countries [1][2][3][4][5][6], but no systematic guidelines have been published up to now.…”

Section: Introductionmentioning

confidence: 99%

Italian consensus guidelines for chronic pancreatitis

Frulloni

Falconi

Gabbrielli

et al. 2010

Digestive and Liver Disease

166

112

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This paper gives practical guidelines for diagnosis and treatment of chronic pancreatitis. Statements have been elaborated by working teams of experts, by searching for and analysing the literature, and submitted to a consensus process by using a Delphi modified procedure. The statements report recommendations on clinical and nutritional approach, assessment of pancreatic function, treatment of exocrine pancreatic failure and of secondary diabetes, treatment of pain and prevention of painful relapses. Moreover, the role of endoscopy in approaching pancreatic pain, pancreatic stones, duct narrowing and dilation, and complications was considered. Recommendations for most appropriate use of various imaging techniques and of ultrasound endoscopy are reported. Finally, a group of recommendations are addressed to the surgical treatment, with definition of right indications, timing, most appropriate procedures and techniques in different clinical conditions and targets, and clinical and functional outcomes following surgery. © 2010 Editrice Gastroenterologica Italiana S.r.l

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Section: Introductionmentioning

confidence: 99%

Italian consensus guidelines for chronic pancreatitis

Frulloni

Falconi

Gabbrielli

et al. 2010

Digestive and Liver Disease

166

112

View full text Add to dashboard Cite

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“…Adherence to the old belief that pancreatic rest is important has significantly delayed the use of early enteral nutrition in severe pancreatitis. A large controlled study of patients with AP showed that enteral nutrition significantly reduced septic complications, but made no difference to the rate of multiple organ failure or death (Meier et al, 2006).…”

Section: Introductionmentioning

confidence: 99%

Effect of Lactobacillus plantarum enteral feeding on the gut permeability and septic complications in the patients with acute pancreatitis

et al. 2007

Eur J Clin Nutr

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Objective: To study the effect of the Lactobacillus plantarum (LP) enteral feeding on the gut permeability and sepsis in the patients with acute pancreatitis. Subjects: Seventy-six subjects who stayed over 1 week in the hospital completed the study. Subjects were not treated with any lactobacillus supplement before the intervention. Methods: Seventy-six patients with acute pancreatitis were randomly divided into two groups, parenteral nutrition (PN) group (n ¼ 38) and ecoimmunonutrition (EIN) group supplied by LP enteral feeding (n ¼ 36). The acute physiology and chronic health evaluation score, Balthazar CT score, CRP, fecal bacterial species and DNA fingerprint profiles as well as the potentially pathologenic organisms in nasogastric aspirate were determined on the day of admission and on the 8 day. The intestinal permeability was assessed by measurement of the ratio of lactulose/rhamnose on the day of admission and on days 5 and 8. The rate of organ failure, septic complications and death cases were evaluated at the 8 day. Results: Following 7 days treatment, 38.9% patients in the EIN group were colonized with multiple organisms compared to 73.7% in the PN group (Po0.01), and 30.6% patients in the EIN grew potentially pathogenic organisms compared to 50% patients in PN group (Po0.05). The fecal bacterial DNA fingerprint profiles were less, the amount of lactobacteria and bifydobacteria decreased, and the amount of enterococci increased in PN group as compared with EIN group, Po0.05. By day 8, the lactulose/rhamnose ratio in EIN group were lower than that in PN group at days 5 and 8, Po0.05. The patients with LP got a better clinical outcomes as compared with the patients with PN. Conclusion: EIN enteral feeding can attenuate disease severity, improve the intestinal permeability and clinical outcomes.

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“…However, in several studies and guidelines, the superiority of EN/PN has been emphasized (McClave et al, 1997;Marik and Zaloga, 2004;Meier et al, 2006). PN is still a choice in patient who could not be fed orally or intolerant.…”

Section: Discussionmentioning

confidence: 99%

“…However, TPN is still a choice for the patients suffering from the mild AP with nausea and vomit (Meier et al, 2002(Meier et al, , 2006.…”

Section: Introductionmentioning

confidence: 99%

Effects of glutamine-enriched total parenteral nutrition on acute pancreatitis

et al. 2007

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Aim: This study was performed to determine the effects of glutamine enriched total parenteral nutrition (TPN) on the patients with acute pancreatitis (AP). Method: Forty patients with AP, who had Ranson's score between 2 and 4 received either standard TPN (control group) or TPN with glutamine (treatment group). The patients in the treatment group received TPN containing 0.3 g/kg/days glutamine. At the end of the study, patients were evaluated for nutritional and inflammatory parameters, length of TPN and length of hospital stay.Results: The length of TPN applications were 10.573.6 days and 11.672.5 days, and the length of hospital stays were 14.274.4 and 16.473.9 days for the treatment and control groups (NS), and the complication rates in the treatment and control groups were 10 and 40%, respectively (Po0.05). The transferrin level increased by 11.7% in the group that received glutamine-enriched TPN (Po0.05), whereas the transferrin level decreased by 12.1% in the control group (NS). At the end of the study, slight but not significant changes were determined in both groups in fasting blood sugar, albumin, blood urea nitrogen (BUN), creatinine, total cholesterol concentrations, aspartate aminotransferase (AST), alanine transaminase (ALT) and lactate dehydrogenase (LDH) activities, leukocytes, CD 4 , CD 8 , serum Zn, Ca and P levels compare to the baseline levels (NS). Significant decreases were determined in serum lipase, amylase activities and C-reactive protein (CRP) levels in both groups (Po0.05). Conclusions:The results of this study have shown that glutamine supplementation to TPN have beneficial effects on the prevention of complications in patients with AP.

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ESPEN Guidelines on Enteral Nutrition: Pancreas

Cited by 252 publications

References 63 publications

Italian consensus guidelines for chronic pancreatitis

Italian consensus guidelines for chronic pancreatitis

Effect of Lactobacillus plantarum enteral feeding on the gut permeability and septic complications in the patients with acute pancreatitis

Effects of glutamine-enriched total parenteral nutrition on acute pancreatitis

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