Management of infected pancreatic necrosis in the setting of concomitant rectal cancer:A case report and review of literature
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摘要
BACKGROUND Pancreatitis with infected necrosis is a severe complication of acute pancreatitis and carries with it high rates of morbidity and mortality. The management of infected pancreatic necrosis alongside concomitant colorectal cancer has never been described in literature.CASE SUMMARY A 77 years old gentleman presented to the Emergency Department of our hospital complaining of ongoing abdominal pain for 8 h. The patient had clinical features of pancreatitis with a raised lipase of 3810 U/L, A computed tomography(CT) abdomen confirmed pancreatitis with extensive peri-pancreatic edema. During the course of his admission, the patient had persistent high fevers and delirium thought secondary to infected necrosis, prompting the commencement of broad-spectrum antibiotic therapy with Piperacillin/Tazobactam. Subsequent CT abdomen confirmed extensive pancreatic necrosis(over 70%). Patient was managed with supportive therapy,nutritional support and gut rest initially and improved over the course of his admission and was discharged 42 d post admission. He represented 24 d following his discharge with fever and chills and a repeat CT abdomen scan noted gas bubbles within the necrotic pancreatic tissue thereby confirming infected necrotic pancreatitis. This CT scan also revealed asymmetric thickening of the rectal wall suspicious for malignancy. A rectal cancer was confirmed on flexible sigmoidoscopy. The patient underwent two endoscopic necrosectomies and was treated with intravenous antibiotics and was discharged after 28 d.Within 1 wk post discharge, the patient commenced a course of neoadjuvant radiotherapy and subsequently underwent concomitant chemotherapy prior to undergoing a successful Hartmann's procedure for treatment of his colorectal cancer.CONCLUSION This case highlights the efficacy of endoscopic necrosectomy, early enteral feeding and targeted antibiotic therapy for timely management of infected necrotic pancreatitis. The prompt resolution of pancreatitis permitted the patient to undergo neoadjuvant treatment and resection for his concomitant colorectal cancer.
BACKGROUND Pancreatitis with infected necrosis is a severe complication of acute pancreatitis and carries with it high rates of morbidity and mortality. The management of infected pancreatic necrosis alongside concomitant colorectal cancer has never been described in literature.CASE SUMMARY A 77 years old gentleman presented to the Emergency Department of our hospital complaining of ongoing abdominal pain for 8 h. The patient had clinical features of pancreatitis with a raised lipase of 3810 U/L, A computed tomography(CT) abdomen confirmed pancreatitis with extensive peri-pancreatic edema. During the course of his admission, the patient had persistent high fevers and delirium thought secondary to infected necrosis, prompting the commencement of broad-spectrum antibiotic therapy with Piperacillin/Tazobactam. Subsequent CT abdomen confirmed extensive pancreatic necrosis(over 70%). Patient was managed with supportive therapy,nutritional support and gut rest initially and improved over the course of his admission and was discharged 42 d post admission. He represented 24 d following his discharge with fever and chills and a repeat CT abdomen scan noted gas bubbles within the necrotic pancreatic tissue thereby confirming infected necrotic pancreatitis. This CT scan also revealed asymmetric thickening of the rectal wall suspicious for malignancy. A rectal cancer was confirmed on flexible sigmoidoscopy. The patient underwent two endoscopic necrosectomies and was treated with intravenous antibiotics and was discharged after 28 d.Within 1 wk post discharge, the patient commenced a course of neoadjuvant radiotherapy and subsequently underwent concomitant chemotherapy prior to undergoing a successful Hartmann's procedure for treatment of his colorectal cancer.CONCLUSION This case highlights the efficacy of endoscopic necrosectomy, early enteral feeding and targeted antibiotic therapy for timely management of infected necrotic pancreatitis. The prompt resolution of pancreatitis permitted the patient to undergo neoadjuvant treatment and resection for his concomitant colorectal cancer.
BACKGROUND Pancreatitis with infected necrosis is a severe complication of acute pancreatitis and carries with it high rates of morbidity and mortality. The management of infected pancreatic necrosis alongside concomitant colorectal cancer has never been described in literature.CASE SUMMARY A 77 years old gentleman presented to the Emergency Department of our hospital complaining of ongoing abdominal pain for 8 h. The patient had clinical features of pancreatitis with a raised lipase of 3810 U/L, A computed tomography(CT) abdomen confirmed pancreatitis with extensive peri-pancreatic edema. During the course of his admission, the patient had persistent high fevers and delirium thought secondary to infected necrosis, prompting the commencement of broad-spectrum antibiotic therapy with Piperacillin/Tazobactam. Subsequent CT abdomen confirmed extensive pancreatic necrosis(over 70%). Patient was managed with supportive therapy,nutritional support and gut rest initially and improved over the course of his admission and was discharged 42 d post admission. He represented 24 d following his discharge with fever and chills and a repeat CT abdomen scan noted gas bubbles within the necrotic pancreatic tissue thereby confirming infected necrotic pancreatitis. This CT scan also revealed asymmetric thickening of the rectal wall suspicious for malignancy. A rectal cancer was confirmed on flexible sigmoidoscopy. The patient underwent two endoscopic necrosectomies and was treated with intravenous antibiotics and was discharged after 28 d.Within 1 wk post discharge, the patient commenced a course of neoadjuvant radiotherapy and subsequently underwent concomitant chemotherapy prior to undergoing a successful Hartmann's procedure for treatment of his colorectal cancer.CONCLUSION This case highlights the efficacy of endoscopic necrosectomy, early enteral feeding and targeted antibiotic therapy for timely management of infected necrotic pancreatitis. The prompt resolution of pancreatitis permitted the patient to undergo neoadjuvant treatment and resection for his concomitant colorectal cancer.
引文
1 van Brunschot S,Fockens P,Bakker OJ,Besselink MG,Voermans RP,Poley JW,Gooszen HG,Bruno M,van Santvoort HC.Endoscopic transluminal necrosectomy in necrotising pancreatitis:a systematic review.Surg Endosc 2014;28:1425-1438[PMID:24399524 DOI:10.1007/s00464-013-3382-9]
2 van Santvoort HC,Bakker OJ,Bollen TL,Besselink MG,Ahmed Ali U,Schrijver AM,Boermeester MA,van Goor H,Dejong CH,van Eijck CH,van Ramshorst B,Schaapherder AF,van der Harst E,Hofker S,Nieuwenhuijs VB,Brink MA,Kruyt PM,Manusama ER,van der Schelling GP,Karsten T,Hesselink EJ,van Laarhoven CJ,Rosman C,Bosscha K,de Wit RJ,Houdijk AP,Cuesta MA,Wahab PJ,Gooszen HG;Dutch Pancreatitis Study Group.A conservative and minimally invasive approach to necrotizing pancreatitis improves outcome.Gastroenterology 2011;141:1254-1263[PMID:21741922 DOI:10.1053/j.gastro.2011.06.073]
3 Besselink MG,van Santvoort HC,Buskens E,Boermeester MA,van Goor H,Timmerman HM,Nieuwenhuijs VB,Bollen TL,van Ramshorst B,Witteman BJ,Rosman C,Ploeg RJ,Brink MA,Schaapherder AF,Dejong CH,Wahab PJ,van Laarhoven CJ,van der Harst E,van Eijck CH,Cuesta MA,Akkermans LM,Gooszen HG;Dutch Acute Pancreatitis Study Group.Probiotic prophylaxis in predicted severe acute pancreatitis:a randomised,double-blind,placebo-controlled trial.Lancet 2008;371:651-659[PMID:18279948 DOI:10.1016/S0140-6736(08)60207-X]
4 Baron TH,Morgan DE.Acute necrotizing pancreatitis.N Engl J Med 1999;340:1412-1417[PMID:10228193 DOI:10.1056/nejm199905063401807]
5 Beger HG,Rau B,Mayer J,Pralle U.Natural course of acute pancreatitis.World J Surg 1997;21:130-135[PMID:8995067 DOI:10.1007/s002689900204]
6 Kokosis G,Perez A,Pappas TN.Surgical management of necrotizing pancreatitis:an overview.World JGastroenterol 2014;20:16106-16112[PMID:25473162 DOI:10.3748/wjg.v20.i43.16106]
7 El Boukili I,Boschetti G,Belkhodja H,Kepenekian V,Rousset P,Passot G.Update:Role of surgery in acute necrotizing pancreatitis.J Visc Surg 2017;154:413-420[PMID:29113713 DOI:10.1016/j.jviscsurg.2017.06.008]
8 Banks PA,Freeman ML;Practice Parameters Committee of the American College of Gastroenterology.Practice guidelines in acute pancreatitis.Am J Gastroenterol 2006;101:2379-2400[PMID:17032204DOI:10.1111/j.1572-0241.2006.00856.x]
9 Balthazar EJ,Robinson DL,Megibow AJ,Ranson JH.Acute pancreatitis:value of CT in establishing prognosis.Radiology 1990;174:331-336[PMID:2296641 DOI:10.1148/radiology.174.2.2296641]
10 Boumitri C,Brown E,Kahaleh M.Necrotizing Pancreatitis:Current Management and Therapies.Clin Endosc 2017;50:357-365[PMID:28516758 DOI:10.5946/ce.2016.152]
11 Zerem E.Treatment of severe acute pancreatitis and its complications.World J Gastroenterol 2014;20:13879-13892[PMID:25320523 DOI:10.3748/wjg.v20.i38.13879]
12 van Brunschot S,van Grinsven J,van Santvoort HC,Bakker OJ,Besselink MG,Boermeester MA,Bollen TL,Bosscha K,Bouwense SA,Bruno MJ,Cappendijk VC,Consten EC,Dejong CH,van Eijck CH,Erkelens WG,van Goor H,van Grevenstein WMU,Haveman JW,Hofker SH,Jansen JM,Laméris JS,van Lienden KP,Meijssen MA,Mulder CJ,Nieuwenhuijs VB,Poley JW,Quispel R,de Ridder RJ,R?mkens TE,Scheepers JJ,Schepers NJ,Schwartz MP,Seerden T,Spanier BWM,Straathof JWA,Strijker M,Timmer R,Venneman NG,Vleggaar FP,Voermans RP,Witteman BJ,Gooszen HG,Dijkgraaf MG,Fockens P;Dutch Pancreatitis Study Group.Endoscopic or surgical step-up approach for infected necrotising pancreatitis:a multicentre randomised trial.Lancet 2018;391:51-58[PMID:29108721 DOI:10.1016/S0140-6736(17)32404-2]
13 van Santvoort HC,Besselink MG,Bakker OJ,Hofker HS,Boermeester MA,Dejong CH,van Goor H,Schaapherder AF,van Eijck CH,Bollen TL,van Ramshorst B,Nieuwenhuijs VB,Timmer R,Laméris JS,Kruyt PM,Manusama ER,van der Harst E,van der Schelling GP,Karsten T,Hesselink EJ,van Laarhoven CJ,Rosman C,Bosscha K,de Wit RJ,Houdijk AP,van Leeuwen MS,Buskens E,Gooszen HG;Dutch Pancreatitis Study Group.A step-up approach or open necrosectomy for necrotizing pancreatitis.N Engl JMed 2010;362:1491-1502[PMID:20410514 DOI:10.1056/NEJMoa0908821]
14 Haghshenasskashani A,Laurence JM,Kwan V,Johnston E,Hollands MJ,Richardson AJ,Pleass HC,Lam VW.Endoscopic necrosectomy of pancreatic necrosis:a systematic review.Surg Endosc 2011;25:3724-3730[PMID:21656324 DOI:10.1007/s00464-011-1795-x]
15 Kumar N,Conwell DL,Thompson CC.Direct endoscopic necrosectomy versus step-up approach for walled-off pancreatic necrosis:comparison of clinical outcome and health care utilization.Pancreas 2014;43:1334-1339[PMID:25083997 DOI:10.1097/MPA.0000000000000213]
16 Zhao G,Wang CY,Wang F,Xiong JX.Clinical study on nutrition support in patients with severe acute pancreatitis.World J Gastroenterol 2003;9:2105-2108[PMID:12970916 DOI:10.1007/s00535-012-0737-2]
17 Shaw JH,Wolfe RR.Glucose,fatty acid,and urea kinetics in patients with severe pancreatitis.The response to substrate infusion and total parenteral nutrition.Ann Surg 1986;204:665-672[PMID:3098198]
18 Gupta R,Patel K,Calder PC,Yaqoob P,Primrose JN,Johnson CD.A randomised clinical trial to assess the effect of total enteral and total parenteral nutritional support on metabolic,inflammatory and oxidative markers in patients with predicted severe acute pancreatitis(APACHE II>or=6).Pancreatology 2003;3:406-413[PMID:14526151 DOI:10.1159/000073657]
19 Chandrasegaram MD,Plank LD,Windsor JA.The impact of parenteral nutrition on the body composition of patients with acute pancreatitis.JPEN J Parenter Enteral Nutr 2005;29:65-73[PMID:15772382 DOI:10.1177/014860710502900265]
20 Wereszczynska-Siemiatkowska U,Swidnicka-Siergiejko A,Siemiatkowski A,Dabrowski A.Early enteral nutrition is superior to delayed enteral nutrition for the prevention of infected necrosis and mortality in acute pancreatitis.Pancreas 2013;42:640-646[PMID:23508012 DOI:10.1097/MPA.0b013e318271bb61]
21 Petrov MS,van Santvoort HC,Besselink MG,van der Heijden GJ,Windsor JA,Gooszen HG.Enteral nutrition and the risk of mortality and infectious complications in patients with severe acute pancreatitis:a meta-analysis of randomized trials.Arch Surg 2008;143:1111-1117[PMID:19015471 DOI:10.1001/archsurg.143.11.1111]
22 Petrov MS,Whelan K.Comparison of complications attributable to enteral and parenteral nutrition in predicted severe acute pancreatitis:a systematic review and meta-analysis.Br J Nutr 2010;103:1287-1295[PMID:20370944 DOI:10.1017/S0007114510000887]
23 Quan H,Wang X,Guo C.A meta-analysis of enteral nutrition and total parenteral nutrition in patients with acute pancreatitis.Gastroenterol Res Pract 2011;2011:698248[PMID:21687619 DOI:10.1155/2011/698248]
24 Petrov MS,Kukosh MV,Emelyanov NV.A randomized controlled trial of enteral versus parenteral feeding in patients with predicted severe acute pancreatitis shows a significant reduction in mortality and in infected pancreatic complications with total enteral nutrition.Dig Surg 2006;23:336-344;discussion344-345[PMID:17164546 DOI:10.1159/000097949]
25 Al-Omran M,Albalawi ZH,Tashkandi MF,Al-Ansary LA.Enteral versus parenteral nutrition for acute pancreatitis.Cochrane Database Syst Rev 2010;CD002837[PMID:20091534 DOI:10.1002/14651858.CD002837.pub2]
26 Eatock FC,Chong P,Menezes N,Murray L,Mc Kay CJ,Carter CR,Imrie CW.A randomized study of early nasogastric versus nasojejunal feeding in severe acute pancreatitis.Am J Gastroenterol 2005;100:432-439[PMID:15667504 DOI:10.1111/j.1572-0241.2005.40587.x]
27 Wang G,Wen J,Xu L,Zhou S,Gong M,Wen P,Xiao X.Effect of enteral nutrition and ecoimmunonutrition on bacterial translocation and cytokine production in patients with severe acute pancreatitis.J Surg Res 2013;183:592-597[PMID:23726433 DOI:10.1016/j.jss.2012.12.010]
28 Mazaki T,Ishii Y,Takayama T.Meta-analysis of prophylactic antibiotic use in acute necrotizing pancreatitis.Br J Surg 2006;93:674-684[PMID:16703633 DOI:10.1002/bjs.5389]
29 Piciucchi M,Merola E,Marignani M,Signoretti M,Valente R,Cocomello L,Baccini F,Panzuto F,Capurso G,Delle Fave G.Nasogastric or nasointestinal feeding in severe acute pancreatitis.World JGastroenterol 2010;16:3692-3696[PMID:20677342 DOI:10.3748/wjg.v16.i29.3692]
30 Singh N,Sharma B,Sharma M,Sachdev V,Bhardwaj P,Mani K,Joshi YK,Saraya A.Evaluation of early enteral feeding through nasogastric and nasojejunal tube in severe acute pancreatitis:a noninferiority randomized controlled trial.Pancreas 2012;41:153-159[PMID:21775915 DOI:10.1097/MPA.0b013e318221c4a8]
31 Swaroop VS,Chari ST,Clain JE.Severe acute pancreatitis.JAMA 2004;291:2865-2868[PMID:15199038 DOI:10.1001/jama.291.23.2865]
32 Runkel NS,Moody FG,Smith GS,Rodriguez LF,La Rocco MT,Miller TA.The role of the gut in the development of sepsis in acute pancreatitis.J Surg Res 1991;51:18-23[PMID:2067354 DOI:10.1016/0022-4804(91)90064-S]
33 Pederzoli P,Bassi C,Vesentini S,Campedelli A.A randomized multicenter clinical trial of antibiotic prophylaxis of septic complications in acute necrotizing pancreatitis with imipenem.Surg Gynecol Obstet1993;176:480-483[PMID:8480272 DOI:10.1055/s-2007-1018835]
34 Sainio V,Kemppainen E,Puolakkainen P,Taavitsainen M,Kivisaari L,Valtonen V,Haapiainen R,Schr?der T,Kivilaakso E.Early antibiotic treatment in acute necrotising pancreatitis.Lancet 1995;346:663-667[PMID:7658819 DOI:10.1016/S0140-6736(95)92280-6]
35 Nordback I,Sand J,Saaristo R,Paajanen H.Early treatment with antibiotics reduces the need for surgery in acute necrotizing pancreatitis--a single-center randomized study.J Gastrointest Surg 2001;5:113-8;discussion 118-20[PMID:11331472 DOI:10.1016/S1091-255X(01)80021-4]
2 van Santvoort HC,Bakker OJ,Bollen TL,Besselink MG,Ahmed Ali U,Schrijver AM,Boermeester MA,van Goor H,Dejong CH,van Eijck CH,van Ramshorst B,Schaapherder AF,van der Harst E,Hofker S,Nieuwenhuijs VB,Brink MA,Kruyt PM,Manusama ER,van der Schelling GP,Karsten T,Hesselink EJ,van Laarhoven CJ,Rosman C,Bosscha K,de Wit RJ,Houdijk AP,Cuesta MA,Wahab PJ,Gooszen HG;Dutch Pancreatitis Study Group.A conservative and minimally invasive approach to necrotizing pancreatitis improves outcome.Gastroenterology 2011;141:1254-1263[PMID:21741922 DOI:10.1053/j.gastro.2011.06.073]
3 Besselink MG,van Santvoort HC,Buskens E,Boermeester MA,van Goor H,Timmerman HM,Nieuwenhuijs VB,Bollen TL,van Ramshorst B,Witteman BJ,Rosman C,Ploeg RJ,Brink MA,Schaapherder AF,Dejong CH,Wahab PJ,van Laarhoven CJ,van der Harst E,van Eijck CH,Cuesta MA,Akkermans LM,Gooszen HG;Dutch Acute Pancreatitis Study Group.Probiotic prophylaxis in predicted severe acute pancreatitis:a randomised,double-blind,placebo-controlled trial.Lancet 2008;371:651-659[PMID:18279948 DOI:10.1016/S0140-6736(08)60207-X]
4 Baron TH,Morgan DE.Acute necrotizing pancreatitis.N Engl J Med 1999;340:1412-1417[PMID:10228193 DOI:10.1056/nejm199905063401807]
5 Beger HG,Rau B,Mayer J,Pralle U.Natural course of acute pancreatitis.World J Surg 1997;21:130-135[PMID:8995067 DOI:10.1007/s002689900204]
6 Kokosis G,Perez A,Pappas TN.Surgical management of necrotizing pancreatitis:an overview.World JGastroenterol 2014;20:16106-16112[PMID:25473162 DOI:10.3748/wjg.v20.i43.16106]
7 El Boukili I,Boschetti G,Belkhodja H,Kepenekian V,Rousset P,Passot G.Update:Role of surgery in acute necrotizing pancreatitis.J Visc Surg 2017;154:413-420[PMID:29113713 DOI:10.1016/j.jviscsurg.2017.06.008]
8 Banks PA,Freeman ML;Practice Parameters Committee of the American College of Gastroenterology.Practice guidelines in acute pancreatitis.Am J Gastroenterol 2006;101:2379-2400[PMID:17032204DOI:10.1111/j.1572-0241.2006.00856.x]
9 Balthazar EJ,Robinson DL,Megibow AJ,Ranson JH.Acute pancreatitis:value of CT in establishing prognosis.Radiology 1990;174:331-336[PMID:2296641 DOI:10.1148/radiology.174.2.2296641]
10 Boumitri C,Brown E,Kahaleh M.Necrotizing Pancreatitis:Current Management and Therapies.Clin Endosc 2017;50:357-365[PMID:28516758 DOI:10.5946/ce.2016.152]
11 Zerem E.Treatment of severe acute pancreatitis and its complications.World J Gastroenterol 2014;20:13879-13892[PMID:25320523 DOI:10.3748/wjg.v20.i38.13879]
12 van Brunschot S,van Grinsven J,van Santvoort HC,Bakker OJ,Besselink MG,Boermeester MA,Bollen TL,Bosscha K,Bouwense SA,Bruno MJ,Cappendijk VC,Consten EC,Dejong CH,van Eijck CH,Erkelens WG,van Goor H,van Grevenstein WMU,Haveman JW,Hofker SH,Jansen JM,Laméris JS,van Lienden KP,Meijssen MA,Mulder CJ,Nieuwenhuijs VB,Poley JW,Quispel R,de Ridder RJ,R?mkens TE,Scheepers JJ,Schepers NJ,Schwartz MP,Seerden T,Spanier BWM,Straathof JWA,Strijker M,Timmer R,Venneman NG,Vleggaar FP,Voermans RP,Witteman BJ,Gooszen HG,Dijkgraaf MG,Fockens P;Dutch Pancreatitis Study Group.Endoscopic or surgical step-up approach for infected necrotising pancreatitis:a multicentre randomised trial.Lancet 2018;391:51-58[PMID:29108721 DOI:10.1016/S0140-6736(17)32404-2]
13 van Santvoort HC,Besselink MG,Bakker OJ,Hofker HS,Boermeester MA,Dejong CH,van Goor H,Schaapherder AF,van Eijck CH,Bollen TL,van Ramshorst B,Nieuwenhuijs VB,Timmer R,Laméris JS,Kruyt PM,Manusama ER,van der Harst E,van der Schelling GP,Karsten T,Hesselink EJ,van Laarhoven CJ,Rosman C,Bosscha K,de Wit RJ,Houdijk AP,van Leeuwen MS,Buskens E,Gooszen HG;Dutch Pancreatitis Study Group.A step-up approach or open necrosectomy for necrotizing pancreatitis.N Engl JMed 2010;362:1491-1502[PMID:20410514 DOI:10.1056/NEJMoa0908821]
14 Haghshenasskashani A,Laurence JM,Kwan V,Johnston E,Hollands MJ,Richardson AJ,Pleass HC,Lam VW.Endoscopic necrosectomy of pancreatic necrosis:a systematic review.Surg Endosc 2011;25:3724-3730[PMID:21656324 DOI:10.1007/s00464-011-1795-x]
15 Kumar N,Conwell DL,Thompson CC.Direct endoscopic necrosectomy versus step-up approach for walled-off pancreatic necrosis:comparison of clinical outcome and health care utilization.Pancreas 2014;43:1334-1339[PMID:25083997 DOI:10.1097/MPA.0000000000000213]
16 Zhao G,Wang CY,Wang F,Xiong JX.Clinical study on nutrition support in patients with severe acute pancreatitis.World J Gastroenterol 2003;9:2105-2108[PMID:12970916 DOI:10.1007/s00535-012-0737-2]
17 Shaw JH,Wolfe RR.Glucose,fatty acid,and urea kinetics in patients with severe pancreatitis.The response to substrate infusion and total parenteral nutrition.Ann Surg 1986;204:665-672[PMID:3098198]
18 Gupta R,Patel K,Calder PC,Yaqoob P,Primrose JN,Johnson CD.A randomised clinical trial to assess the effect of total enteral and total parenteral nutritional support on metabolic,inflammatory and oxidative markers in patients with predicted severe acute pancreatitis(APACHE II>or=6).Pancreatology 2003;3:406-413[PMID:14526151 DOI:10.1159/000073657]
19 Chandrasegaram MD,Plank LD,Windsor JA.The impact of parenteral nutrition on the body composition of patients with acute pancreatitis.JPEN J Parenter Enteral Nutr 2005;29:65-73[PMID:15772382 DOI:10.1177/014860710502900265]
20 Wereszczynska-Siemiatkowska U,Swidnicka-Siergiejko A,Siemiatkowski A,Dabrowski A.Early enteral nutrition is superior to delayed enteral nutrition for the prevention of infected necrosis and mortality in acute pancreatitis.Pancreas 2013;42:640-646[PMID:23508012 DOI:10.1097/MPA.0b013e318271bb61]
21 Petrov MS,van Santvoort HC,Besselink MG,van der Heijden GJ,Windsor JA,Gooszen HG.Enteral nutrition and the risk of mortality and infectious complications in patients with severe acute pancreatitis:a meta-analysis of randomized trials.Arch Surg 2008;143:1111-1117[PMID:19015471 DOI:10.1001/archsurg.143.11.1111]
22 Petrov MS,Whelan K.Comparison of complications attributable to enteral and parenteral nutrition in predicted severe acute pancreatitis:a systematic review and meta-analysis.Br J Nutr 2010;103:1287-1295[PMID:20370944 DOI:10.1017/S0007114510000887]
23 Quan H,Wang X,Guo C.A meta-analysis of enteral nutrition and total parenteral nutrition in patients with acute pancreatitis.Gastroenterol Res Pract 2011;2011:698248[PMID:21687619 DOI:10.1155/2011/698248]
24 Petrov MS,Kukosh MV,Emelyanov NV.A randomized controlled trial of enteral versus parenteral feeding in patients with predicted severe acute pancreatitis shows a significant reduction in mortality and in infected pancreatic complications with total enteral nutrition.Dig Surg 2006;23:336-344;discussion344-345[PMID:17164546 DOI:10.1159/000097949]
25 Al-Omran M,Albalawi ZH,Tashkandi MF,Al-Ansary LA.Enteral versus parenteral nutrition for acute pancreatitis.Cochrane Database Syst Rev 2010;CD002837[PMID:20091534 DOI:10.1002/14651858.CD002837.pub2]
26 Eatock FC,Chong P,Menezes N,Murray L,Mc Kay CJ,Carter CR,Imrie CW.A randomized study of early nasogastric versus nasojejunal feeding in severe acute pancreatitis.Am J Gastroenterol 2005;100:432-439[PMID:15667504 DOI:10.1111/j.1572-0241.2005.40587.x]
27 Wang G,Wen J,Xu L,Zhou S,Gong M,Wen P,Xiao X.Effect of enteral nutrition and ecoimmunonutrition on bacterial translocation and cytokine production in patients with severe acute pancreatitis.J Surg Res 2013;183:592-597[PMID:23726433 DOI:10.1016/j.jss.2012.12.010]
28 Mazaki T,Ishii Y,Takayama T.Meta-analysis of prophylactic antibiotic use in acute necrotizing pancreatitis.Br J Surg 2006;93:674-684[PMID:16703633 DOI:10.1002/bjs.5389]
29 Piciucchi M,Merola E,Marignani M,Signoretti M,Valente R,Cocomello L,Baccini F,Panzuto F,Capurso G,Delle Fave G.Nasogastric or nasointestinal feeding in severe acute pancreatitis.World JGastroenterol 2010;16:3692-3696[PMID:20677342 DOI:10.3748/wjg.v16.i29.3692]
30 Singh N,Sharma B,Sharma M,Sachdev V,Bhardwaj P,Mani K,Joshi YK,Saraya A.Evaluation of early enteral feeding through nasogastric and nasojejunal tube in severe acute pancreatitis:a noninferiority randomized controlled trial.Pancreas 2012;41:153-159[PMID:21775915 DOI:10.1097/MPA.0b013e318221c4a8]
31 Swaroop VS,Chari ST,Clain JE.Severe acute pancreatitis.JAMA 2004;291:2865-2868[PMID:15199038 DOI:10.1001/jama.291.23.2865]
32 Runkel NS,Moody FG,Smith GS,Rodriguez LF,La Rocco MT,Miller TA.The role of the gut in the development of sepsis in acute pancreatitis.J Surg Res 1991;51:18-23[PMID:2067354 DOI:10.1016/0022-4804(91)90064-S]
33 Pederzoli P,Bassi C,Vesentini S,Campedelli A.A randomized multicenter clinical trial of antibiotic prophylaxis of septic complications in acute necrotizing pancreatitis with imipenem.Surg Gynecol Obstet1993;176:480-483[PMID:8480272 DOI:10.1055/s-2007-1018835]
34 Sainio V,Kemppainen E,Puolakkainen P,Taavitsainen M,Kivisaari L,Valtonen V,Haapiainen R,Schr?der T,Kivilaakso E.Early antibiotic treatment in acute necrotising pancreatitis.Lancet 1995;346:663-667[PMID:7658819 DOI:10.1016/S0140-6736(95)92280-6]
35 Nordback I,Sand J,Saaristo R,Paajanen H.Early treatment with antibiotics reduces the need for surgery in acute necrotizing pancreatitis--a single-center randomized study.J Gastrointest Surg 2001;5:113-8;discussion 118-20[PMID:11331472 DOI:10.1016/S1091-255X(01)80021-4]