医学
急性胰腺炎
内科学
肠外营养
胰腺炎
子群分析
指南
随机对照试验
胃肠病学
儿科
荟萃分析
病理
作者
Xi-Ying Liang,Xinan Wu,Ying Tian,Hang Gao,Jingjing Chen,Quanxin Feng
标识
DOI:10.1097/mcg.0000000000001886
摘要
Background: The aim of this study was to summarize the optimal strategy for early feeding in patients with acute pancreatitis. Methods: The search was undertaken in electronic databases, which compared early with delayed feeding in acute pancreatitis. The primary outcome was the length of hospital stay (LOHS). The second outcomes were intolerance of refeeding, mortality, and total cost of each patient. This meta-analysis followed the “Preferred Reporting Items for Systematic Reviews and Meta-analyses” guideline. Research is registered by PROSPERO, CRD42020192133. Results: A total of 20 trials involving 2168 patients were included, randomly assigned to the early feeding group (N = 1033) and delayed feeding group (N = 1135). The LOHS was significantly lower in the early feeding group than the delayed feeding group (mean difference: −2.35, 95% CI: −2.89 to −1.80; P < 0.0001), no matter the mild or severe subgroup ( P int = 0.69). The secondary outcome of feeding intolerance and mortality were no significant difference (risk ratio: 0.96, 0.40 to 2.16, P = 0.87 and 0.91, 0.57 to 1.46, P = 0.69; respectively). Moreover, the hospitalization cost was significantly less in the early feeding group, resulting in an average savings of 50%. In patients with severe pancreatitis, early feeding after 24 hours may be beneficial ( P int = 0.001). Conclusion: Early oral feeding can significantly reduce the LOHS and hospitalization costs in patients with acute pancreatitis without increasing feeding intolerance or mortality. In patients with severe pancreatitis, early feeding after 24 hours may be beneficial.
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