Jejunal feeding, even when instituted late, improves outcomes in patients with severe pancreatitis and peritonitis

This study assessed the feasibility and effectiveness of jejunal feeding (J F) after surgery due to secondary peritonitis or failed conservative therap y of severe pancreatitis. Of 60 patients, 30 were randomly assigned to rece ive postoperative JF and the remaining 30 constituted the control group. Ac ute Physiology and Chronic Health Evaluation III nutritional intake, system ic inflammatory response syndrome, and outcomes were measured. Patients in JF group received the daily mean of 1294.6 (362.6) kcal including 830.6 (37 2.7.0) kcal enterally, versus 472.8 (155.8) kcal daily in the control group (P < 0.0001). There were fewer complications in the JF patients, with no s ignificant difference; length of stay in the intensive care unit and in the hospital did not differ. The frequency of systemic inflammatory response s yndrome was similar in both groups, but outcomes differed. The first surgic al intervention resulted in 3.3% of relaparotomies in TF patients, caused b y unresolved peritonitis, versus 26.7% in the control subjects (P = 0.03). Recovery of bowel transit took significantly less time in the JE patients ( mean: 54.6 h versus 76.8 h in control subjects, P = 0.01). JF resulted in 3 .3% mortality as opposed to 23.3% in the control group (P = 0.05). In concl usion, JF is feasible and effective in postoperative treatment of patients due to secondary peritonitis or severe pancreatitis. Improved bowel and per itoneal function could be the main impact of JF. (C) Elsevier Science Inc. 2001.