Meta-analysis of the effectiveness of parenteral nutrition and enteral nutrition in acute pancreatitis

Objective To analyze the effects of total parenteral nutrition (TPN) and enteral nutri- tion (EN) in patients with acute pancreatitis. Methods Electronic databases from January 1966 to March 2011 about randomized controlled trial of nutrition therapy in patients with acute pancreatitis were enrolled and Meta-analysis of these randomized controlled trial was used, the measurement index were morbidity, infection rate, multiple organ failure (MOF) rate, surgery intervention rate and length of stay. Results A total of 13 trials was included. Compared with conventional parenteral nutrition, morbidity of enteral nutrition in patients with acute pancreatitis reduced by 61% (95% CI = 24%~63%, P = 0.0001) , and infection rate reduced by 45% (95% CI = 38%~79%, P < 0.01) , and the multiple organ failure reduced by 69% (95% CI = 20%~48%, P < 0.01) , and the surgery intervention reduced by 73% (95% CI = 18%~42%, P < 0.01) . However, there was no statistically significant about the length of stay between EN and PN. Conclusions In patients with acute pancreatitis, enteral nutrition significantly reduced mortality, infections, multiple organ failure and surgery intervention compared to those who received TPN. This data suggests that EN should be considered the better way for patients with acute pancreatitis requiring nutritional support. Key words: Meta-analysis; Acute pancreatitis; Enteral nutrition; Parenteral nutrition