P484 - IMPACT OF ENTERAL VS. PARENTERAL NUTRITION ON TREATMENT OUTCOMES IN ACUTE PANCREATITIS

P484

IMPACT OF ENTERAL VS. PARENTERAL NUTRITION ON TREATMENT OUTCOMES IN ACUTE PANCREATITIS

M. Malinowski^1,*, A. Lewczak¹, D. Bogdanowska-Charkiewicz¹

¹Clinic of Gastroenterology and Internal Diseases of the Medical University of Bialystok, Medical University of Bialystok, Bialystok, Poland

Rationale: The aim of the study was to determine whether early enteral nutrition (EN) compared to parenteral nutrition (PN) improves outcomes in acute pancreatitis by reducing endotoxin levels and strengthening intestinal barrier integrity to lower clinical complications.

Methods: Data from four clinical studies were included, identified by a PubMed advanced search using the query:

((“Acute Pancreatitis”[Mesh] OR “acute pancreatitis”[tiab]) AND (“Enteral Nutrition”[Mesh] OR “enteral nutrition”[tiab] OR “enteral feeding”[tiab]) AND (“Parenteral Nutrition”[Mesh] OR “parenteral nutrition”[tiab] OR “parenteral feeding”[tiab])).

These studies, involving patients with severe acute pancreatitis, evaluated endotoxin levels, intestinal permeability (lactulose-to-mannitol ratio), SIRS incidence, severity scores (Ranson, APACHE-II), and hospitalization duration. Data were analyzed using the Student’s t-test and χ² analysis (p<0.05).

Results: EN significantly reduced serum endotoxin levels and improved intestinal permeability compared to PN (p<0.05). Patients receiving EN had lower severity scores and a reduced risk of multi-organ failure, although differences in SIRS incidence and mortality did not reach statistical significance.

Conclusion: These findings suggest that early EN is more beneficial than PN in treating acute pancreatitis by enhancing gut barrier function and reducing inflammation, resulting in better clinical outcomes.

References: Shen QX, Xu GX, Shen MH Effect of early enteral nutrition on endotoxin in serum and intestinal permeability in patients with severe acute pancreatitis.

Hui L, Zang K, Wang M, Shang F, Zhang G. Comparison of the Preference of Nutritional Support for Patients With Severe Acute Pancreatitis

Márta K, Szabó AN, Pécsi D, Varjú P, Bajor J, Gódi S, et al. High versus low energy administration in the early phase of acute pancreatitis (GOULASH trial): protocol of a multicentre randomised double-blind clinical trial.

Disclosure of Interest: None declared