BACKGROUND & AIMS:To assess the success rate of a self-propelling nasojejunal feeding tube in patients with acute pancreatitis. METHODS:All patients admitted for acute pancreatitis were included. A self-propelling nasojejunal feeding tube was introduced into the stomach, and gastrointestinal motility was stimulated using metoclopramide. If the tube failed to advance to the ligament of Treitz, a nasojejunal tube was placed endoscopically. RESULTS:A total of 108 patients, 94 with necrotizing pancreatitis (Balthazar D/E) and 14 with nonnecrotizing pancreatitis (Balthazar B/C), were referred for artificial nutrition. In 11 cases, ileus persisted and parenteral nutrition was initiated. Among the remaining 97 patients, 5 refused tube placement. The self-propelling feeding tube was inserted in 92 patients with successful migration to the ligament of Treitz in 61% (n = 56) and failure in 39% (n = 36). Of the 36 patients with an initial failed placement, endoscopic placement of a nasojejunal tube was successful 80% of the time (29 patients). The success rate of a nasojejunal self-propelling feeding tube placement correlated directly with the severity of the acute pancreatitis (92% in B/C vs 61% in D vs 48% in E; P < .05). CONCLUSIONS:Use of a self-propelling nasojejunal tube is a simple technique that can be successfully performed in the majority of patients with acute pancreatitis. The utility of this procedure in the most severe cases of acute pancreatitis continues to pose a challenge.

译文

背景与目的:评估自推进鼻空肠饲管在急性胰腺炎患者中的成功率。
方法:纳入所有因急性胰腺炎入院的患者。将自推进式鼻空肠喂养管插入胃中,并使用甲氧氯普胺刺激胃肠蠕动。如果试管无法前进至Treitz韧带,则在内窥镜下放置鼻空肠管。
结果:总共108例患者接受了人工营养,其中94例为坏死性胰腺炎(Balthazar D / E),而14例为非坏死性胰腺炎(Balthazar B / C)。在11例中,肠梗阻持续存在,并开始了肠胃外营养。在其余的97名患者中,有5名拒绝了导管的放置。自推进式饲管已插入92例成功迁移至Treitz韧带的患者中,占61%(n = 56),失败者占39%(n = 36)。在最初放置失败的36例患者中,鼻空肠管的内镜放置成功率为80%(29例)。鼻空肠自推进式饲管放置的成功率与急性胰腺炎的严重程度直接相关(B / C组为92%,D组为61%,E组为48%; P <.05)。
结论:使用自推进鼻空肠管是一种简单的技术,可以在大多数急性胰腺炎患者中成功进行。在最严重的急性胰腺炎病例中该方法的实用性继续构成挑战。

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