The Use of Nasojejunal Nutrition in Patients with Chronic Pancreatitis

摘要

Context Abdominal pain,malabsorption and diabetes all contribute to a negative impact upon nutritionalstatus in chronic pancreatitis and no validated standard for the nutritionalmanagement of patients exists. Objective To assess the effect of nasojejunalnutrition in chronic pancreatitis patients. Design All consecutive chronicpancreatitis patients fed via the nasojejunal route between January 2004 andDecember 2007 were included in the study. Patients were assessed viaretrospective review of case notes. Results Fifty-eight chronicpancreatitis patients (35 males, 23 females; median age 46 years) were included.Patients were discharged after a median of 14 days and nasojejunal nutritioncontinued for a median of 47 days. Forty-six patients (79.3%) reported resolutionof their abdominal pain and cessation of opioid analgesia intake over the studyperiod and median weight gain at 6 weeks following nutritional cessation was +1kg (range -24 to +27 kg; P=0.454). Twelve (20.7%) patients reported recurrenceof their pain during the follow-up period and complications were both minor andinfrequent. Significant improvements were noted in most blood parametersmeasured, including: sodium (from 134.8 to 138.1 mEq/L; P<0.001); urea (from3.4 to 5.1 mmol/L; P<0.001); creatinine (from 58.3 to 60.3 μmol/L; P<0.001);corrected calcium (from 2.24 to 2.35 mmol/L; P=0.018); albumin (from 34.5 to 38.7g/L; P=0.002); CRP (from 73.0 to 25.5 mg/L; P=0.006); and haemoglobin (from 11.8to 12.4 g/dL; P=0.036). Conclusion Nasojejunal nutrition, commenced inhospital and continued at home, is safe, efficacious and well tolerated inpatients with severe chronic pancreatitis and is effective in helping torelieve pain and diminish analgesic requirements.