The evolution of treatment of acute Pancreatitis in our hospital

Introduction: The treatment of acute pancreatitis has changed a lot in recent years. Nowadays we apply enteral feeding in acute pancreatitis more successfully. Previously, on the contrary, intravenous fluid therapy was used. Methods: We compared the results of patients treated with acute pancreatitis in 2004 and in 2014. Results: In 2004, 125 patients were treated with acute pancreatitis in our hospital, out of which 80 patients in the Department of Internal Medicine (78 mild acute pancreatitis, 2 severe), 33 patients in the Department of Surgery due to moderate to severe acute pancreatitis and 12 patients in the Intensive Care Unit due to severe acute pancreatitis. In the first four weeks after the onset of symptoms, operation was needed in 24 cases (20% of all cases, 51% of the severe cases). Three patients received enteral feeding (2.4% of all cases, 6.4% of the severe cases). Ten patients died during hospitalization (8% of all cases, 21.2% of the severe cases). The patients with moderate to severe acute pancreatitis lost 10 – 18% of their weight and spent 18 – 62 days in the hospital. In 2014, 101 patients were treated with acute pancreatitis in our hospital (41 mild, 60 moderate to severe), out of which 41 patients in the Department of Internal Medicine due to mild acute pancreatitis, 56 patients in the Department of Gastroenterology due to moderate to severe acute pancreatitis, 2 patients in the Department of Surgery and 1 patient in the Intensive Care Unit due to severe acute pancreatitis. In the first four weeks after the onset of symptoms, operation wasn't needed. Forty eight patients received enteral feeding (47.5% of all cases, 80% of the moderate to severe cases). One patient died during hospitalization, who was 94 years old (0.99% of all cases, 0.6% of the moderate to severe cases). The patients with moderate to severe acute pancreatitis lost 2 – 10% of their weight (80% received enteral feeding) and spent 14 – 30 days in the hospital. Enteral feeding was continued even after discharge in 20 cases. Conclusions: In acute pancreatitis we use enteral feeding more often then 10 years ago, because it reduces weight loss, allows faster recovery, better comfort and shorter hospitalization of the patients. It is a more efficient treatment than intravenous fluid therapy which also lowers treatment costs.