| [ Summary ] |
Acute pancreatitis is a common and critical disease associated with complications. Severe acute pancreatitis cases have high mortality despite the improvements in intensive care management. Recent meta‒analyses suggest that enteral nutrition is more effective than conventional treatment comprising discontinuation of oral intake and initiation of total parenteral nutrition. Furthermore, systematic reviews revealed that the effectiveness of early enteral nutrition for severe acute pancreatitis was associated with significant reductions in all the infections, in pancreatic infection, in the length of hospitalization, and in the mortality rate. Enteral nutrition is recommended due to a lower risk of associated infectious complications compared to parental nutrition. From these findings, the revised Japanese Guidelines for the management of acute pancreatitis (Japanese Guidelines 2015) state that in severe cases, it is more significant to prevent infection rather than focus on the route of nutritional support. Therefore, enteral nutrition can be implemented in severe acute pancreatitis cases with no associated intestinal complications. In addition, enteral nutrition should be started within at least 48 hours of admission. Nevertheless, many physicians have been reported to be noncompliant with the current guidelines on nutritional support in the management of acute pancreatitis. In order to improve patient outcome, compliance with the guidelines is necessary. |