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.