Fat Emulsion for Acute Pancreatitis: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

XIAO Qingchuan ¹ , WU Taixiang ² ,  DUI Danhua ¹ , LAN Tiangang ¹ , LI Jiehui ¹

1. Department of Hepatobiliary Surgery, Affiliated Hospital of Zunyi Medical College, Zunyi 563003, China;2. Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, 610041, China;

Corresponding author：

DUI Danhua, Email: xqcab@yahoo.com.cn

Keywords：

Fat emulsion; Acute pancreatitis; Systematic review; Meta-analysis

DOI：

10.7507/1672-2531.20090084

Video：

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Objective　 To assess the efficacy and safety of fat emulsion (FE) for acute pancreatitis (AP).
Methods 　We searched the electronic biological databases: Cochrane Controlled Trials Register (Issue 2, 2007), Medline(1996 to April 2007), EMBASE (1984 to April 2007), Chinese biological medical database (1978 to April 2007). We alsodid handsearching to identify other published and unpublished data. Data collection and undertaken by two reviewers
according to the Cochrane Handbook for Reviews of Intervention. Randomized controlled trials (RCTs) or quasi-RCTs
comparing FE versus glucose in the treatment of AP were collected. Pooled estimates of overall treatment effect were
calculated using the RevMan 4.2.10 according to available data from included studies. Otherwise, qualitative descriptive
analysis was performed.
Results　 In total, 10 clinic control trials finally (include 314 participant) met the eligible criteria. ① To long chain triglyceride (LCT), the comparison of overall mortality (relative risk, 0.73; 95%CI, 0.34 to 1.58; P=0.26) and complications (P gt;0.05) showed no significant difference. One study reported LCT cannot reduce hospital stay (P gt;0.1). The effects of LCT on cholesterol and triglyceride were inconsistent with respect to the course of treatment. ② However, there were no changes of the cholesterol and triglyceride levels secondary to the medium chain triglyceride and long chain triglyceride (MCT/LCT) (P gt;0.05, respectively) according to one study. ③ No severe adverse events were reported.
Conclusions 　The evidence currently available cannot conclude that FE is safe and effective, though LCT may decrease
the mortality of AP. Therefore, more high-quality trails are needed.

Citation： XIAO Qingchuan,WU Taixiang,DUI Danhua,LAN Tiangang,LI Jiehui. Fat Emulsion for Acute Pancreatitis: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2009, 09(4): 452-457. doi: 10.7507/1672-2531.20090084 Copy

1.	Jap TS, Jenq SF, Wu YC, et al. Mutations in the lipoprotein lipase geneas a cause of hypertriglyceridemia and pancreatitis in Taiwan. Pancreas, 2003, 27(2): 122-126.
2.	Bradley, EL 3rd. A clinically based classification system for acute pancreatitis, Summary of the International Symposium on Acute Pancreatitis, Atlanta, Ga, September 11 through 13, 1992. Arch Surg, 1993, 128(5): 586-590.
3.	中华医学会外科学会胰腺学组. 急性胰腺炎的诊断及分级标准(1996年第二次方案). 中华外科杂志, 1997, 35(12): 773-775.
4.	吴泰相, 刘关键. 隐蔽分组 (分配隐藏) 和盲法的概念、实施与报告. 中国循证医学杂志, 2007, 7(3): 222-225.
5.	Sitzmann JV, Steinborn PA, Zinner MJ, et al. Total parenteral nutrition and alternate energy substrates in treatment of severe acute pancreatitis. Surg, Gynecol & Obstet, 1989, 168(4): 311-317.
6.	刘牧林, 曹伟新, 尹浩然, 等. Intralipid与Lipofundin在重症胰腺炎病人中的应用. 肠外与肠内营养, 1998, 5(2): 90-93.
7.	马良, 孙小丰, 林佩娣, 等. 肠外营养在老年糖尿病合并胰腺炎治疗中的应用. 上海医药, 1999, 20(10): 11-12.
8.	周亚魁, 史海安, 何跃明, 等. 重症胰腺炎病人对静脉输注脂肪乳剂耐受性的临床研究. 中华消化杂志, 1999, 19(1): 35-37.
9.	黄克俭, 花天放, 刘小弟, 等. 长链脂肪酸对重症急性胰腺炎病人脂质介质的影响. 外科理论与实践, 2000, 5(1): 31-33.
10.	吴海福, 吴肇汉, 吴国豪, 等. 脂肪乳剂对急性坏死性胰腺炎患者影响的前瞻性研究. 中华外科杂志, 1995, 33(5): 261-264.
11.	Szczygiel B, Pertkiewicz M, Wojcik Z. Lipid-associated total parenteral nutrition in the treatment of severe acute pancreatitis. Journal of Clinical Nutrition and Gastroenterology, 1991, 6(4): 203-213.
12.	Lochs H, Kleinberger G, Kletter K, et al. Effect of parenteral administration of fat on the glucose and fat metabolism in acute pancreatitis. Infusionstherapie und Klinische Ernahrung, 1982, 9(3): 127-129.
13.	Dürr GH, Schaefers A, Maroske D, et al. A controlled study on the use of intravenous fat in patients suffering from acute attacks of pancreatitis. Infusionstherapie Und Klinische Ernährung, 1985, 12 (3): 128-133.
14.	朱江帆, 黄志强, 刘永雄, 等. 急性胰腺炎时输注脂肪乳剂作为胃肠外营养的临床研究. 中华消化杂志, 1992, 12(4): 195-197.
15.	Moher D, MSc. The CONSORT Guidelines: improving the quality of research. Consolidated Standards of Reporting Trials, Interview by Bonnie Horrigan. Altern Ther Health Med, 2002, 8(3): 103-108.

1. Jap TS, Jenq SF, Wu YC, et al. Mutations in the lipoprotein lipase geneas a cause of hypertriglyceridemia and pancreatitis in Taiwan. Pancreas, 2003, 27(2): 122-126.
2. Bradley, EL 3rd. A clinically based classification system for acute pancreatitis, Summary of the International Symposium on Acute Pancreatitis, Atlanta, Ga, September 11 through 13, 1992. Arch Surg, 1993, 128(5): 586-590.
3. 中华医学会外科学会胰腺学组. 急性胰腺炎的诊断及分级标准(1996年第二次方案). 中华外科杂志, 1997, 35(12): 773-775.
4. 吴泰相, 刘关键. 隐蔽分组 (分配隐藏) 和盲法的概念、实施与报告. 中国循证医学杂志, 2007, 7(3): 222-225.
5. Sitzmann JV, Steinborn PA, Zinner MJ, et al. Total parenteral nutrition and alternate energy substrates in treatment of severe acute pancreatitis. Surg, Gynecol & Obstet, 1989, 168(4): 311-317.
6. 刘牧林, 曹伟新, 尹浩然, 等. Intralipid与Lipofundin在重症胰腺炎病人中的应用. 肠外与肠内营养, 1998, 5(2): 90-93.
7. 马良, 孙小丰, 林佩娣, 等. 肠外营养在老年糖尿病合并胰腺炎治疗中的应用. 上海医药, 1999, 20(10): 11-12.
8. 周亚魁, 史海安, 何跃明, 等. 重症胰腺炎病人对静脉输注脂肪乳剂耐受性的临床研究. 中华消化杂志, 1999, 19(1): 35-37.
9. 黄克俭, 花天放, 刘小弟, 等. 长链脂肪酸对重症急性胰腺炎病人脂质介质的影响. 外科理论与实践, 2000, 5(1): 31-33.
10. 吴海福, 吴肇汉, 吴国豪, 等. 脂肪乳剂对急性坏死性胰腺炎患者影响的前瞻性研究. 中华外科杂志, 1995, 33(5): 261-264.
11. Szczygiel B, Pertkiewicz M, Wojcik Z. Lipid-associated total parenteral nutrition in the treatment of severe acute pancreatitis. Journal of Clinical Nutrition and Gastroenterology, 1991, 6(4): 203-213.
12. Lochs H, Kleinberger G, Kletter K, et al. Effect of parenteral administration of fat on the glucose and fat metabolism in acute pancreatitis. Infusionstherapie und Klinische Ernahrung, 1982, 9(3): 127-129.
13. Dürr GH, Schaefers A, Maroske D, et al. A controlled study on the use of intravenous fat in patients suffering from acute attacks of pancreatitis. Infusionstherapie Und Klinische Ernährung, 1985, 12 (3): 128-133.
14. 朱江帆, 黄志强, 刘永雄, 等. 急性胰腺炎时输注脂肪乳剂作为胃肠外营养的临床研究. 中华消化杂志, 1992, 12(4): 195-197.
15. Moher D, MSc. The CONSORT Guidelines: improving the quality of research. Consolidated Standards of Reporting Trials, Interview by Bonnie Horrigan. Altern Ther Health Med, 2002, 8(3): 103-108.

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