Timing and method of oral refeeding in mild acute pancreatitis: a systematic review

Abstract

Background: Optimal timing and method of oral refeeding in mild acute pancreatitis (AP) is unclear. Aims: To identify the optimal timing and method of oral refeeding in patients with mild AP. Methods: PubMed and CINAHL were searched to identify randomised control trials (RCTs) for inclusion, and risk of bias was assessed with the Cochrane Collaboration Tool. Results: A total of 10 RCTs were included, six trials assessing timing of oral refeeding and five trials assessing method of oral refeeding. Early refeeding was associated with reduced length of hospital stay (LoHS) in five out of six trials. An immediate full caloric diet was associated with reduced LoHS in two out of five trials. There was a statistical increase in calories consumed in the group receiving immediate full caloric diets in three trials. There were no adverse events. Conclusion: Early oral refeeding can safely reduce LoHS in patients with mild AP. Refeeding with an immediate full caloric diet is safe and can increase calories consumed, ...