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World J Gastrointest Endosc. Dec 16, 2012; 4(12): 526-531
Published online Dec 16, 2012. doi: 10.4253/wjge.v4.i12.526
Published online Dec 16, 2012. doi: 10.4253/wjge.v4.i12.526
Endoscopist’s approach to nutrition in the patient with pancreatitis
Shahzad Iqbal, Jay P Babich, James H Grendell, David M Friedel, Department of Medicine, Division of Gastroenterology, Winthrop University Hospital, Mineola, NY 11501, United States
Author contributions: Iqbal S and Babich JP wrote the paper; Grendell JH and Friedel DM reviewed the paper.
Correspondence to: Shahzad Iqbal, MD, Department of Medicine, Division of Gastroenterology, Winthrop University Hospital, 222 Station Plaza North, Suite 428, Mineola, NY 11501, United States. siqbal@winthrop.org
Telephone: +1-516-6632066 Fax: +1-516-6634617
Received: June 2, 2012
Revised: November 10, 2012
Accepted: December 1, 2012
Published online: December 16, 2012
Revised: November 10, 2012
Accepted: December 1, 2012
Published online: December 16, 2012
Abstract
Nutritional therapy has an important role in the management of patient with severe acute pancreatitis. This article reviews the endoscopist’s approach to manage nutrition in such cases. Enteral feeding has been clearly validated as the preferred route of feeding, and should be started early on admission. Parenteral nutrition should be reserved for patients with contraindications to enteral feeding such as small bowel obstruction. Moreover, nasogastric feeding is safe and as effective as nasojejunal feeding. If a prolonged course of enteral feeding (> 30 d) is required, endoscopic placement of feeding gastrostomy or jejunostomy tubes should be considered.
Keywords: Acute pancreatitis, Nutrition, Enteral nutrition, Total parenteral nutrition, Nasoenteric tube feedings, Percutaneous endoscopic gastrostomy, Percutaneous endoscopic gastro-jejunostomy, Direct percutaneous endoscopic jejunostomy