A meta-analysis of early oral refeeding and quickly increased diet for patients with mild acute pancreatitis

Jiran Zhang, Sha Zhu, Dingyu Tan, Aiwen Ma, Yan Yang, Jiyang Xu

Saudi Journal of Gastroenterology 2019 25(1):14-19

Background/Aim: The objective of the study is to clarify whether early oral refeeding (EORF) and quickly increasing diet (QID) are of benefit to patients with mild acute pancreatitis compared with a traditional oral refeeding strategy. Materials and Methods: Studies were searched in PubMed, Cochrane library, ScienceDirect, SpringerLink, China Biology Medicine disc and Embase. A meta-analysis was then performed, using relapse of abdominal pain, nausea/vomiting, and length of hospital stay (LOHS) as the evaluation indices. Results: Eight trials met the inclusion criteria. For the oral refeeding time group, EORF could significantly decrease the LOHS (mean deviation [MD] −1.97; 95% confidence interval (CI) −3.32 to −0.62;P = 0.004), and there was no significant difference for relapse of abdominal pain (relative risk [RR] 1.17; 95% CI 0.69–2.00;P = 0.56) or nausea/vomiting (RR 1.30; 95% CI 0.19–8.82;P = 0.79) when compared with conventional oral refeeding. For the oral refeeding material group, there was no significant difference for relapse of abdominal pain (RR 0.86; 95% CI 0.53–1.40;P = 0.54), nausea/vomiting (risk difference −0.01; 95% CI −0.19–0.18;P = 0.94), or LOHS (MD −0.88; 95% CI −2.24–0.48;P = 0.20) between the QID and stepwise increasing diet groups. Conclusion: Pure EORF or QID caused no damage to patients with mild acute pancreatitis, and EORF could significantly decrease the LOHS.

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