Challenges of Administering Pancrelipase in Pancreatitis Patients.

OBJECTIVE

This study evaluated nutrition status to determine the impact of a novel approach using elemental nutrition compared to pancrelipase administration in patients with pancreatitis.

METHODS

This retrospective study included adult patients with pancreatitis who were nil per os (NPO) and received elemental nutrition from August 2008 to 2010 (n = 24) or pancrelipase enzyme supplementation (PES) plus nonelemental enteral nutrition from August 2011 to 2013 (n = 41) at a large academic medical center. The primary outcome is the percentage of diarrhea-free days. Secondary outcomes include time-to-goal enteral nutrition from the enteral nutrition initiation and pre-albumin and albumin changes pre- and postenteral nutrition.

RESULTS

There were no statistically significant differences between the 2 groups in percentage of diarrhea-free days (46.80% ± 29.03% vs 53.45% ± 36.76%, p = 0.45). Additionally, there were no differences in secondary outcomes of time-to-goal enteral nutrition and pre-albumin and albumin changes pre- and postenteral nutrition.

CONCLUSION

Utilizing elemental nutrition compared to PES plus nonelemental enteral nutrition in patients with pancreatitis was not associated with a significant reduction in percentage of diarrhea-free days, time-to-goal enteral nutrition, and nutrition status. A multicenter, prospective, randomized, controlled trial is warranted to further evaluate the efficacy of elemental nutrition in patients with pancreatitis.