Enteral nutrition during acute pancreatitis: feasibility study of a self-propeeling spiral distal end jejunal tube
Karsenti, D.; Viguier, Jérôme.; Bourlier, P.; d'alteroche, L.; Barbieux, J-Pierre.; Metman, E-Henry.; Dorval, E.
Gastroenterologie Clinique et Biologique 27(6-7): 614-617
2003
ISSN/ISBN: 0399-8320 PMID: 12910227 Document Number: 552560
Objective: The aim of our study was to evaluate the feasibility of enteral jejunal nutrition for acute pancreatitis using a self-propelling spiral distal end jejunal tube. Methods: Sixteen consecutive patients with acute pancreatitis in whom Flocare(R) tubes were placed for enteral nutrition were included in this open prospective study. All of them had pancreatic and/or peripancreatic necrosis (Balthazar gtoreqD). The median computed topography index was 5 (range 3-10) and the median Ranson score was 2 (range 0-5). The nasoenteric Flocare(R) tube (spiral distal end) was inserted in the stomach at the bedside. Self progression into the jejunum was assessed by X-ray at 1, 7 and 12 hours and then every 24 hours for 4 days. The rate of successful tube self-placement in the jejunum and the time to successful placement were noted. Results: Insertion was successful in 12 of 16 patients (75%). Treitz's ligament was reached in a median of 12 hours (range 1-96 hours). For the remaining patients, the tube was successfully repositioned under fluoroscopic guidance in 2 and withdrawn in 2, one for oral renutrition and one to change to a weighted jejunal tube. No tube dysfunction or recurrence of pancreatitis occurred during the entire period of enteral nutrition. Conclusions: This study suggests that the nasoenteric Flocare(R) tube can be used effectively and safely in early enteral jejunal nutrition for severe acute pancreatitis, without endoscopic or radiological manipulation.