Total Parenteral Nutrition in Pancreatic Disease

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Abstract
Total parenteral nutrition (TPN) was given to 121 patients admitted with severe pancreatitis (73), chronic pancreatitis (23) or pancreatic malignancy (25) over 104 mo. No adverse effects on the pancreas were detected from the TPN, including the provision of i.v. fat. Nutritional status was maintained or improved in all groups, including patients undergoing surgical procedures and those experiencing marked stress. No significant impact on the clinical course of pancreatitis was observed, although the death rate in acute pancreatitis (15.2%) and complicated pancreatitis (18.5%) compares favorably with other published series where early surgical intervention was undertaken. There was an increased catheter-related septic risk in patients with complicated pancreatitis (14.8%) and with chronic pancreatitis (17.4%). No increase septic risk was seen in patients with acute pancreatitis or pancreatic malignancy. Patients (82%) with acute pancreatitis required an average of 87 U of insulin/day while patients (78%) with chronic pancreatitis required an average of 54 U/day. TPN proved to be safe, effective and well-tolerated in those patients with pancreas disorders.