title: Safety and efficacy of radiological percutaneous jejunostomy for decompression of malignant small bowel obstruction.
abstract: OBJECTIVE
  This study aimed to evaluate the safety and efficacy of percutaneous radiological jejunostomy (PRJ) and stent placement in patients with malignant small bowel obstructions (MSBO).
  
  
  METHODS
  A total of 21 patients (mean age 60 years) with single (n = 4) or multiple (n = 17) MSBO underwent PRJ following jejunopexy. The medical records and imaging studies were retrospectively reviewed to evaluate the technical/clinical success and complications. Clinical success was determined by symptomatic relief and radiologic bowel decompression.
  
  
  RESULTS
  PRJ using a 12- or 14-F drainage catheter was technically successful in all patients. Eleven patients required placement of an 18-F nasogastric tube across one (n = 3), two (n = 6) and three (n = 2) obstructions to achieve clinical success. Subsequently, self-expandable stents were placed through the PRJ tracts to recanalise MSBO in four patients. Clinical success was achieved in 18 patients (85.7 %). The median food intake capacity score improved from 4.0 to 2.0 (P = 0.001). There were one major (peritonitis, 4.8 %) and six minor complications (28.6 %)
  
  
  CONCLUSIONS
  PRJ using a nasogastric tube across the obstructions is an effective palliative treatment for MSBO. The PRJ tract can be used as an approach route for stent placement to recanalise MSBO. However, dedicated devices should be developed to reduce frequent procedure-related complications.
  
  
  CONCLUSIONS
  • Bowel decompression provides palliative treatment in malignant small bowel obstruction • Percutaneous radiological jejunostomy (PRJ) is a safe and effective palliative treatment. • Long tube placement across obstructions facilitates adequate drainage of multiple bowel obstructions. • PRJ tract can be used for stent placement to approach MSBO recanalisation.
authors: Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul, Korea.
authors: Young-Joo
authors: YJ
authors: Kim
authors: Chang Jin
authors: CJ
authors: Yoon
authors: Nak Jong
authors: NJ
authors: Seong
authors: Sung-Gwon
authors: SG
authors: Kang
authors: Seung-Won
authors: SW
authors: An
authors: Young-Nam
authors: YN
authors: Woo
mesh_terms: D000008:Abdominal Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D007421:Intestine, Small / Q000000981:diagnostic imaging / Q000601:surgery*; D007582:Jejunostomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D025321:Surgery, Computer-Assisted / Q000009:adverse effects / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult
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