Abstract

MACHAIN VEGA, Gustavo et al. Nutritional management and oral feeding initiation in acute biliary pancreatitis. Reviewof cases in Segunda Cátedra de Clínica Quirúrgica, Hospital de Clínicas, period 2013 - 2018. Cir. parag. [online]. 2021, vol.45, n.3, pp.7-10. ISSN 2307-0420.  https://doi.org/10.18004/sopaci.2021.diciembre.7.

Objective: To determine the relationship between the initiation of oral feeding with the severity of acute biliary pancreatitis.

Materials and Methods: observational and analytical study of patients with age 18 or over, with acute biliary pancreatitis during period 2008-2013.

Results: in 95 cases of acute pancreatitis, 69 were women and 26 men, with an average age of 45 years. Only 29.4% had normal weight, the rest were overweight or obese. The restart of the oral feeding was related to the severity of pancreatitis, earlier when mildes: mild 2 days, moderate 3 days, and severe 7 days on average (ANOVA p = 0.003). The start of oral feeding was delayed due to persistent abdominal pain in 71 patients, in 23 due to nausea, and in 21 due to abdominal distention. There was only a significant association with abdominal distention (OR = 3.03 95% CI [1.09-8.42] p = 0.02). 22 patients had two or more SIRS criteria; they were 6 times more likely to have a gastric rest longer than 24 hours (OR = 6.01 95% CI [1.98-18.19] p = 0.001). On refeeding, on the first day, patients with a 24-hour fast progressed to a solid diet, with a 48-hour fast to a soft diet, and after the 72-hour fast they were left with clear liquids (ANOVA p = 0.01). Albumin levels decrease with increasing fasting days. (ANOVA p 0.002).

Conclusion: The severity of pancreatitis, the persistence of abdominal symptoms and the presence of SIRS delay the initiation of the oral feeding in cases of acute biliary pancreatitis, and the longer the delay, the lower the albumin levels.

Keywords : oral feeding; acute pancreatitis; fasting.

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