Six randomised controlled trials (n=264) were included. Four studies scored 3 on the Jadad scale; two studies scored 2. None of the studies were double blinded. Only two studies reported adequate concealment of allocation. Four studies reported appropriate randomisation.
Enteral nutrition resulted in a decreased need for insulin therapy (six randomised controlled trials, relative risk=0.41, 95% confidence interval: 0.24, 0.70, p=0.001, I2=15%), incidence of hyperglycaemia (three randomised controlled trials, relative risk=0.53, 95% confidence interval: 0.29, 0.98, p=0.04. I2=22%), total infectious complications (six randomised controlled trials, relative risk=0.47, 95% confidence interval: 0.26, 0.85, p=0.01, I2=14%) and in-hospital mortality (six randomised controlled trials, relative risk=0.60, 95% confidence interval: 0.19, 1.88, p=0.38, I2=75%) compared to parenteral nutrition. Findings for need for insulin therapy and infectious complications remained similar when only patients with severe pancreatitis were considered, but enteral nutrition resulted in a statistically significant reduction in mortality (relative risk=0.32, 95% confidence interval: 0.11, 0.98, p=0.04, I2=9%).
There was no evidence of publication bias.