Clinical research on combined therapy of total parenteral nutrition with enteral nutrition for severe acute pancreatitis

Objective To assess the therapeutic efficacy of total parenteral nutrition (TPN) combined with enteral nutrition (EN) in patients with severe acute pancreatitis (SAP).Methods In this prospective, open-label and clinical trial, 101 consecutive patients with diagnosis of severe acute pancreatitis were enrolled. Fifty-six patients were allocated in total parenteral nutrition group and 45 patients in total parenteral nutrition combined with enteral nutrition group. The diagnostic criteria of severe acute pancreatitis was made upon classity by standard in the international rivers of 1992 Atlanta. The severity of severe acute pancreatitis was slso ascertained based on Ranson's criteria, APACHE Ⅱ or Balthazar CT scoring. Results There were no statistical differences between two groups in age, gender and severity of severe acute pancreatitis. Compared with total parenteral nutrition group, patients in total parenteral nutrition combined with enteral nutrition group had a obvious improvement in APACHE Ⅱ and Binder's scoring and a extremely reduction in complication, hospitalization days, hospitalization expenses and mortality. However, serum amylase and lactate dehydrogenase activity kept in the same level between two groups. Conclusion This study indicates that such combination therapy can improve the prognosis and undernutrition of severe acute pancreatitis.