A meta-analysis of early oral refeeding and quickly increased diet for patients with mild acute pancreatitis

Saudi J Gastroenterol. 2019 Jan-Feb;25(1):14-19. doi: 10.4103/sjg.SJG_240_18.

Abstract

Background/aim: The objective of the study is to clarify whether early oral refeeding (EORF) and quickly increasing diet (QID) are of benefit to patients with mild acute pancreatitis compared with a traditional oral refeeding strategy.

Materials and methods: Studies were searched in PubMed, Cochrane library, ScienceDirect, SpringerLink, China Biology Medicine disc and Embase. A meta-analysis was then performed, using relapse of abdominal pain, nausea/vomiting, and length of hospital stay (LOHS) as the evaluation indices.

Results: Eight trials met the inclusion criteria. For the oral refeeding time group, EORF could significantly decrease the LOHS (mean deviation [MD] -1.97; 95% confidence interval (CI) -3.32 to -0.62;P = 0.004), and there was no significant difference for relapse of abdominal pain (relative risk [RR] 1.17; 95% CI 0.69-2.00;P = 0.56) or nausea/vomiting (RR 1.30; 95% CI 0.19-8.82;P = 0.79) when compared with conventional oral refeeding. For the oral refeeding material group, there was no significant difference for relapse of abdominal pain (RR 0.86; 95% CI 0.53-1.40;P = 0.54), nausea/vomiting (risk difference -0.01; 95% CI -0.19-0.18;P = 0.94), or LOHS (MD -0.88; 95% CI -2.24-0.48;P = 0.20) between the QID and stepwise increasing diet groups.

Conclusion: Pure EORF or QID caused no damage to patients with mild acute pancreatitis, and EORF could significantly decrease the LOHS.

Keywords: Abdominal pain; acute pancreatitis; length of hospital stay; oral refeeding.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Review

MeSH terms

  • Abdominal Pain / diagnosis
  • Abdominal Pain / epidemiology*
  • Acute Disease
  • Diet / adverse effects*
  • Diet / methods
  • Feeding Behavior / classification
  • Feeding Behavior / physiology*
  • Female
  • Humans
  • Incidence
  • Length of Stay / trends
  • Male
  • Nausea / diagnosis
  • Nausea / epidemiology
  • Pancreatitis / epidemiology*
  • Pancreatitis / mortality
  • Recurrence
  • Vomiting / diagnosis
  • Vomiting / epidemiology