Experimental study of early enteral nutrition on acute necrotizing pancreatitis in rats

Objective:To investigate the feasibility of early enteral nutrition(EEN) on acute necrotizing pancreatitis(ANP),and the influence of EEN on ameliorating the bacterial and endotoxic translocations from intestine tract.Methods:Sixtyeight SD rats were randomly divided into 3 groups:sham operation group(group A, n =12),experiment control group(group B, n =27) and treatment group(group C, n=29 ).Right internal jugular vine indwelling catheter was inserted for normal saline transfusion,2 ml/h.Pancreasbile duct retrogrand puncture and jejunum fistula were made in all rats.While pancreasbile duct retrogrand puncture was accomplished,normal saline 0 2 ml/100 g were injected for group A,and 3 5% taurocholic acid 0 2 ml/100 g were injected for group B and C.In group C Elental(10 ml,4 184 kJ/L) was given by jejunum fistula 1 hour after the set up of ANP model,3 times per 24 hours.Results:The pathology examination after 24 hours showed that the pancreas tissue were normal in all rats of group A(12/12,100 00%);dot and(or) patch necrosis,hemorrhage,a great deal of inflammatory cell soakage in all rats of group B(27/27,100 00%) and in 21 rats of group C( 21/29, 72 41%);and a interstitial edema,a little of inflammatory cell soakage in another 8 rats of group C( 8/29, 27 59%).Survival rate of 24 hours was evidently improved in group C than in group B( P 0 01).The serum endotoxin levels were obviously higher in group B and group C than in group A(both P 0 01),while that of group C was markedly declined than group B( P 0 05).The lung,kidney,liver,spleen and mesentery lymph nodes(MLN) tissue germiculture counts(colony forming units,cfu/g) were significantly different in 3 groups,and obviously increased in group B and group C than in group A,whereas the tissue germiculture counts in group C was markedly reduced than in group B,there was significantly difference between 2 groups(all P 0 01).Conclusions:EEN by jejunum fistula is safer in ANP cases,it does not aggravate the state of ANP.The survival rate of 24 hours increases obviously,and the bacterial and endotoxic translocations from intestine tract are alleviated.