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La pancreatitis aguda es una patología cuya etiología más frecuente es la litiasis biliar y la ingesta de alcohol. Si bien en el 80% de los pacientes suele tener un curso clínico leve, un 20% de los pacientes presenta una pancreatitis grave que se acompaña de necrosis pancreática, absceso o seudoquiste, con disfunción multiorgánica y una respuesta hipermetabólica exacerbada, siendo estos pacientes los que van a requerir un tratamiento más complejo con soporte nutricional intensivo. En esta puesta al día revisamos la fisiopatología y la nutrición artificial en la pancreatitis aguda, de forma que los estudios clínicos publicados en los últimos años nos proporcionan una evidencia científica suficiente para aconsejar en la pancreatitis aguda la utilización de la nutrición enteral sobre la nutrición parenteral, al presentar menor tasa de complicaciones globales y sepsis, con un coste inferior de la nutrición enteral respecto a la nutrición parenteral.
Palabras clave:
Pancreatitis aguda
Nutrición enteral
Nutrición parenteral
The most frequent etiologies of acute pancreatitis are gallstones and alcohol consumption. Although the clinical course is mild in 80% of patients, severe pancreatitis accompanied by pancreatic necrosis, abscess or pseudocyst, with multiple organ dysfunction and an exaggerated hypermetabolic response, develop in 20% and it is these patients who will require more complex treatment with intensive nutritional support. The present update reviews the physiopathology of artificial nutrition in acute pancreatitis. The clinical studies published in the last few years provide sufficient scientific evidence to allow the use of enteral nutrition to be recommended over parenteral nutrition in acute pancreatitis due to the lower rate of overall complications and sepsis and reduced cost associated with this treatment modality.
Key words:
Acute pancreatitis
Enteral nutrition
Parenteral nutrition
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