NameofjournalWorldJournalofGastroenterology.docxVIP

Name of journal: World Journal of Gastroenterology ESPS Manuscript No: 9408Columns: TOPIC HIGHLIGHTSWJG 20th Anniversary Special Issues (18): PancreatitisEnteral nutrition in acute pancreatitis: A review of the current evidenceOláh A et al Enteral nutrition in acute pancreatitis Attila Oláh, Laszlo Romics JrAttila Oláh, Department of Surgery, Petz Aladár Teaching Hospital, H-9023 Gy?r, HungaryLaszlo Romics Jr, Department of Surgery, Glasgow Victoria Infirmary, Glasgow G42 9TY, United KingdomAuthor contributions: Olah A designed research; Olah A and Romics Jr L performed literature search, analyzed data and wrote the paper.Correspondence to: Attila Oláh, MD, PhD, MRCS, Department of Surgery, Petz Aladár Teaching Hospital, P.O. Box 92, H-9023 Gy?r, Hungary. olaha@petz.gyor.huTelephone: +36–96–418244 Fax: +36–96–507907Received: February 11, 2014 Revised: May 5, 2014Accepted: July 22, 2014 Published online: AbstractThe use of enteral feeding as part of the management of acute pancreatitis dates back almost two decades. This review describes the indications for and limitations of enteral feeding for the treatment of acute pancreatitis using up-to-date evidence-based data. A systematic review was carried out to analyse current data on the use of enteral nutrition in the management of acute pancreatitis. Relevant literature was analysed from the viewpoints of enteral vs parenteral feeding, early vs delayed enteral nutrition, nasogastric vs nasojejunal feeding, and early oral diet and immunonutrition, particularly glutamine and probiotic supplementation. Finally, current applicable guidelines and the effects of these guidelines on clinical practice are discussed. The latest meta-analyses suggest that enteral nutrition significantly reduces the mortality rate of severe acute pancreatitis compared to parenteral feeding. To maintain gut barrier function and prevent early bacterial translocation, enteral feeding should be commenced within the first 24 h of hospital admission.