Читать книгу Clinical Pancreatology for Practising Gastroenterologists and Surgeons - Группа авторов - Страница 113

Bowel rest is no longer the standard of care in AP. In the past, it was believed that allowing patients to take anything by mouth had a theoretical risk of stimulating the pancreas and thereby worsening pancreatitis. However, several studies have now shown that patients initiated on oral feeding early in the course of AP have shorter hospital stay, reduced infectious complications, and decreased mortality [28,49–52]. The current recommendation to initiate early oral feeding relies on the fact that enteral nutrition likely serves to protect the mucosal barrier of the gut and diminish bacterial translocation, thereby reducing the risk of developing infections in the pancreatic necrosis [29]. When compared to parenteral nutrition, early enteral nutrition is associated with decreased rates of overall infection and lower risk of complications [28,49,53,54]. Patients who cannot tolerate immediate oral feeding may require nasogastric tube placement for nutritional support. There is no advantage in placing a nasojejunal tube (post‐pyloric) compared with gastric tube placement [54,55].