Fluoroscopically guided percutaneous jejunostomy with use of a 21-gauge needle: a prospective study in 51 patients.
OBJECTIVE
To assess the safety and clinical efficacy of fluoroscopically guided percutaneous jejunostomy with use of a 21-gauge needle and a single anchor technique in 51 patients.


METHODS
From November 2006 to January 2009, 51 consecutive patients (42 men and nine women; mean age, 63.7 years) underwent percutaneous jejunostomy under fluoroscopic guidance. A 7.5-F multifunctional coil catheter was used to insufflate the jejunum. The distended jejunum was punctured with a 21-gauge needle, with the inserted coil catheter as the target. A single anchor was used. The technical success, number of punctures, procedure time, complications, and follow-up data including 30-day mortality rate were evaluated.


RESULTS
The technical success rate was 100%, and the single anchor technique was used in all but one patient, in whom three anchors were used. The mean number of punctures was 1.7 (range, 1-4), and the mean procedure time was 14.8 minutes (range, 7-29 min). Peritonitis was a major complication in two patients (3.9%), who were treated by changing the catheters from 14 F to 16 F and performing percutaneous drainage procedures. Three minor complications were encountered: superficial cellulitis (n = 2) and severe puncture site pain (n = 1). The 30-day mortality rate was 5.9% (three of 51), although none of the deaths could be attributed to the jejunostomy procedures.


CONCLUSIONS
Fluoroscopically guided percutaneous jejunostomy with use of a 21-gauge needle and the single anchor technique seems to be safe and effective, with high technical success and low complication rates.
Department of Radiology, Henan Tumor Hospital, Zhengzhou, China.
Hong-Tao
HT
Hu
Ji Hoon
JH
Shin
Ho-Young
HY
Song
Jin Hyoung
JH
Kim
Hyun-Ki
HK
Yoon
Dong-Il
DI
Gwon
Gi-Young
GY
Ko
Kyu-Bo
KB
Sung
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002404:Catheterization; D004750:Enteral Nutrition / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D004867:Equipment Design; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007327:Insufflation; D007582:Jejunostomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D008297:Male; D044342:Malnutrition / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D008875:Middle Aged; D009339:Needles; D011446:Prospective Studies; D011677:Punctures / Q000009:adverse effects / Q000295:instrumentation*; D015641:Radiography, Interventional; D013997:Time Factors; D016896:Treatment Outcome