Nutritional management and oral feeding initiation in acute biliary pancreatitis. Review of cases in Segunda Cátedra de Clínica Quirúrgica, Hospital de Clínicas, period 2013 - 2018

Abstract

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...