SYSTEMATIC REVIEW article
Front. Pediatr.
Sec. Pediatric Gastroenterology, Hepatology and Nutrition
Impact of Early Enteral Nutrition on Children with Acute Pancreatitis: a Systematic Review and Meta-analysis
Provisionally accepted
- Children's Hospital of Zhejiang University School of Medicine, Hangzhou, China
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Objective: Pediatric acute pancreatitis (AP) often triggers systemic inflammation and serious complications, yet the optimal nutritional support strategy remains uncertain. This systematic review aims to evaluate the impact of early enteral nutrition (EEN) in children with AP. Methods: We systematically searched for relevant studies (randomized controlled trials and non-randomized studies) comparing EEN with control nutritional strategies in pediatric AP across CNKI, Wanfang, VIP, CBM, PubMed, the Cochrane Library, Embase, and Web of Science from inception to October 2025. Study screening and data extraction were performed independently by two reviewers. This review was conducted and reported following the PRISMA 2020 statement. Meta-analyses were performed using RevMan 5.2 software. Results: Eight studies involving 485 children with AP were included. Meta-analysis showed that, compared to the control group, EEN significantly improved serum albumin levels(SMD = 1.28, 95% CI = 0.68 to 1.88, P < 0.0001), reduced Acute Physiology and Chronic Health Evaluation II (APACHE-II) score (SMD = -2.58, 95% CI = -4.46 to -0.70, P = 0.007), lowered tumor necrosis factor-α (TNF-α) levels (SMD = -2.23, 95% CI = -3.36 to -1.10, P = 0.0001), and decreased the incidence of adverse events (OR =0.27, 95% CI =0.14~0.49, P<0. 0001). Conclusion: EEN may improve nutritional and inflammatory status and reduce adverse events in children with AP. However, due to the limited sample size and heterogeneity among the included studies, further high-quality research is needed to confirm these findings.
Keywords: acute pancreatitis, adverse events, APACHE-II, Early enteral nutrition, Serum Albumin, Systematic review, TNF-α
Received: 26 Nov 2025; Accepted: 13 Feb 2026.
Copyright: © 2026 Rao, Zhou, Zhong, Jiang and Yin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yan Yin
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