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Introduction: Acute pancreatitis is a potentially lethal disease with wide variation in severity ranging from mild and self-limiting to a rapidly progressive illness leading to multiorgan failure. In accordance with this wide variation in clinical presentation, the treatment of acute pancreatitis requires a multidisciplinary approach. Mild acute pancreatitis causes disturbance in the homeostatic mechanism of the body is minimal; the treatment is aimed at supporting the native reparative processes of the body. One of the main supportive mechanisms is adequate and safe nutritional supplementation. Objectives: To assess the occurrence of infective and non-infective complications in cases of acute pancreatitis on early enteral nutrition. Materials & Methods: This is a prospective study conducted on patients who were admitted to SSIMS AND RC Davangere with symptoms suggestive of acute pancreatitis from July 2019 to July 2021. Patients with a clinical picture consistent with the diagnosis of acute pancreatitis, along with more than a 3-fold elevation of serum amylase and elevated serum lipase were considered to have acute pancreatitis. After initial diagnosis and assessment, patients were duly informed regarding the study and consent was obtained. A 16-gauge nasogastric Ryle’s tube was inserted for all patients included in the study. The feeding patterns were initiated depending upon the severity of acute pancreatitis. Feeding was started after calculating the nutrition requirement. In the early feeding group, patients were given a protein powder to achieve a target nutrition in a stepwise manner. The tolerance to feeds, infective and non-infective complications and the time taken to start on an oral diet were noted and analysed. Results: The incidence of infective complications in our study was found to be 2% with none of the infections involving the pancreas itself. The incidence of non-infective complications in our study was found to be 30% with 13% involving the pancreas proper. Conclusions: The use of early enteral feeding does not influence the incidence of infective and non-infective complications in mild and moderate acute pancreatitis. Early enteral feeding delivers nutrition, in a simpler and more cost-effective. Nasogastric and oral feeding reduces the morbidity of the patient by accelerating the return to normal activities.
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Laparoscopic cholecystectomy is one of the most common operations performed in general surgery. Elective laparoscopiccholecystectomy has a low risk for infective complications, and standard guidelines do not recommend prophylactic antibioticuse for low-risk cases. However, the use of antibiotic prophylaxis is very prevalent and the duration and dosage are inconsistentand varies widely among surgeons. This study is being done to assess the role of no antibiotic prophylaxis in the prevention ofwound infection in a patient undergoing elective laparoscopic cholecystectomy.Study Design and Period: The study was conducted in the Department of General Surgery at Christian Medical College,Ludhiana. This was an open labeled study conducted from the period of January 1, 2014, to December 31, 2014.Results: 92 patients suffering from chronic calculous cholecystitis undergoing elective laparoscopic cholecystectomy wereincluded in the study. Group A with 23 cases without prophylactic antibiotic. Group B with 69 cases with two doses of prophylacticantibiotics Inj. cefuroxime 1.5 gram 30 min prior to induction and after 6 h. The majority of our 81patients (88.04%) were females.The male to female ratio was 1:8. 3 patients (3.27%) in Group B had associated comorbidities except for diabetes mellitus. Themajority of patients 14 (60.86%) in Group A had taken 1-2 h of operative time while 58 patients (84.05%) patients in Group Bwith statistical insignificant P = 0.05. There was no fever in Group A patients while in Group B 2 patients (2.89%) had fever onsecond post-operative day which was not related to surgical site infection and that was due to superficial thrombophlebitis. InGroup A 18 patients (78.26%) were discharged on second postoperative days while 46 patients (66.67%) patients in Group Bwere discharged on second postoperative day. 8 patients (11.59%) in Group B were discharged on third postoperative days.There was no statistical difference in the duration of hospitalization between the two groups with P = 0.22. The overall incidenceof postoperative infective complications were nil in both groups either with patients having no prophylactic antibiotic or thosehaving prophylactic antibiotics