title: US and fluoroscopic-guided percutaneous jejunostomy: experience in 49 patients.
abstract: OBJECTIVE
  To assess the feasibility and safety of a variety of techniques for percutaneous jejunostomy.
  
  
  METHODS
  Percutaneous jejunostomy was attempted on 53 occasions in 49 patients under US and fluoroscopic guidance. During the study period, thicker needles, Cope anchors, and intravenous glucagon were introduced to improve access, dilate, and immobilize the jejunum. Technical success rates, complications, catheterization period, and reasons for catheter removal were prospectively studied. Prognostic factors for successful procedures and complications were determined.
  
  
  RESULTS
  Forty-six (87%) procedures were technically successful. Previous gastrointestinal surgery (P = .01) and a combination of thicker needles, Cope anchors, and intravenous glucagon (P = .0001) were associated with a higher technical success rate. Complications (n = 6; pericatheter leakage in four of six) were observed more frequently in older patients (P = .01). The 30-day mortality rate was 17%, one death may have been procedure related. Forty-three catheters were removed (elective, n = 36; other, n = 7) after 1-597 days (median, 49). Three catheters remained in situ for 139-482 days (median, 410).
  
  
  CONCLUSIONS
  Percutaneous jejunostomy is a feasible and relatively safe technique for long-term feeding. Leakage is the main problem, which warrants additional study.
authors.affiliation: Department of Radiology, University Hospital Rotterdam, The Netherlands.
authors.forename: H
authors.initials: H
authors.lastname: van Overhagen
authors.forename: M A
authors.initials: MA
authors.lastname: Ludviksson
authors.forename: J S
authors.initials: JS
authors.lastname: Laméris
authors.forename: A W
authors.initials: AW
authors.lastname: Zwamborn
authors.forename: H W
authors.initials: HW
authors.lastname: Tilanus
authors.forename: J
authors.initials: J
authors.lastname: Dees
authors.forename: B E
authors.initials: BE
authors.lastname: Hansen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004750:Enteral Nutrition; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007582:Jejunostomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D011677:Punctures; D015641:Radiography, Interventional; D018084:Ultrasonography, Interventional