Impact of early enteral nutrition on children with acute pancreatitis: A systematic review and meta analysis.

OBJECTIVE: To systematically evaluate the impact of early enteral nutrition (EEN) on children with acute pancreatitis (AP). METHODS: Randomized controlled trials (RCTs) and quasi-experimental studies investigating the effects of EEN on children with AP were retrieved from databases including China National Knowledge Infrastructure (CNKI), Wanfang, Chinese Scientific Journal Database (VIP), Chinese Biomedical Literature Database (CBM), PubMed, Cochrane Library, Embase, and Web of Science from inception to October 1, 2025. Data analysis was performed using RevMan 5.2 software. RESULTS: Nine trials involving 485 children with AP were included. The analysis revealed that the observation group (EEN) demonstrated significant improvements compared to the control group in the following outcomes: serum albumin (standardized mean difference [SMD] = 1.28, 95% confidence interval [CI] = 0.68-1.88, p < 0.0001), acute physiology and chronic health evaluation II (APACHE-II) score (SMD = -2.58, 95% CI = -4.46 to -0.70, p = 0.007), tumor necrosis factor-α (TNF-α) level (SMD = -2.23, 95% CI = -3.36 to -1.10, p = 0.0001), and incidence of adverse events (odds ratio [OR] = 0.30, 95% CI = 0.17-0.52, p < 0.0001). CONCLUSION: EEN significantly increases serum albumin levels, reduces APACHE-II scores and TNF-α levels, and decreases the incidence of adverse events in children with AP.