Fluoroscopically guided percutaneous jejunostomy: outcomes in 25 consecutive patients.
OBJECTIVE
To assess the feasibility and safety of fluoroscopically guided percutaneous jejunostomy.


METHODS
Between May 1999 and August 2006 percutaneous jejunostomy was attempted in 25 patients. A 5 F vascular catheter (n=20) or a 7.5 F multifunctional coil catheter (n=5) was used to insufflate the jejunum. The distended jejunum was punctured using a 17 G needle (n=19) or a 21 G Chiba needle (n=6) with the inserted catheter as a target. A 12 or 14 F loop feeding tube was inserted after serial dilations. The technical success, complications, 30-day mortality, and in-dwelling period of the feeding tube placement were evaluated.


RESULTS
The technical success rate was 92% (23/25). Technical failures (n=2) resulted from the inability to insufflate the jejunum secondary to failure to pass the catheter through a malignant stricture at the oesophagojejunostomy site and thus subsequent puncture of the undistended jejunum failed, or failure to introduce the Neff catheter into the jejunum. Pericatheter leakage with pneumoperitoneum was a complication in three patients (12%) and was treated conservatively. The 30-day mortality was 13% (3/23); however, there was no evidence that these deaths were attributed to the procedure. Except for four patients who were lost to follow-up and two failed cases, 15 of the 19 jejunostomy catheters were removed because of patient death (n=12) or completion of treatment (n=3), with a mean and median in-dwelling period of 231 and 87 days, respectively.


CONCLUSIONS
Fluoroscopically guided percutaneous jejunostomy is a feasible procedure with a high technical success and a low complication rate. In addition to a 17 G needle, a 21 G needle can safely be used to puncture the jejunum.
Yang
Z Q
ZQ
Department of Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, PR China.
Shin
J H
JH
Song
H-Y
HY
Kwon
J H
JH
Kim
J-W
JW
Kim
K R
KR
Kim
J-H
JH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002404:Catheterization / Q000379:methods; D004750:Enteral Nutrition / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007582:Jejunostomy / Q000295:instrumentation / Q000379:methods* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015641:Radiography, Interventional; D012189:Retrospective Studies; D016896:Treatment Outcome