title: Fluoroscopically guided percutaneous jejunostomy: outcomes in 25 consecutive patients.
abstract: 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.
authors.affiliation: Department of Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, PR China.
authors.forename: Z Q
authors.initials: ZQ
authors.lastname: Yang
authors.forename: J H
authors.initials: JH
authors.lastname: Shin
authors.forename: H-Y
authors.initials: HY
authors.lastname: Song
authors.forename: J H
authors.initials: JH
authors.lastname: Kwon
authors.forename: J-W
authors.initials: JW
authors.lastname: Kim
authors.forename: K R
authors.initials: KR
authors.lastname: Kim
authors.forename: J-H
authors.initials: JH
authors.lastname: Kim
mesh_terms: 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