Application of the "oral simulated tube feeding method" in enteral nutrition for patients with moderately severe acute pancreatitis: a randomized controlled non-inferiority trial comparing the nasogastric feeding route.

OBJECTIVE: To evaluate the efficacy and safety of an "oral simulated tube feeding method" compared to nasogastric feeding in patients with moderately severe acute pancreatitis (MSAP). METHODS: In this randomized controlled non-inferiority trial, 60 MSAP patients were assigned to either the oral simulated tube feeding group (STREAM, n = 31) or the nasogastric group (NG, n = 29). The primary outcome was the 24-h enteral nutrition (EN) tolerance rate. RESULTS: The 24-h tolerance rate in the STREAM group was non-inferior to the NG group (96.8% vs. 69.0%, P < 0.001). Secondary outcomes showed the STREAM group had lower 24-h tolerance scores (1.94 ± 0.26 vs. 3.59 ± 0.34, P < 0.001) and fewer occurrences of abdominal distension (P < 0.001) and nausea (P = 0.025). Additionally, the STREAM group had significantly lower hospitalization costs (P = 0.011), with only 12.9% of patients exceeding 10,000 ¥ compared to 48.3% in the NG group. No significant difference was observed in the length of hospital stay. CONCLUSION: The oral simulated tube feeding method is a non-inferior, safe, and cost-effective alternative to nasogastric feeding for MSAP patients.