title: An improved method of nasojejunal feeding tube placement for patients requiring endoscopic nasobiliary drainage.
abstract: OBJECTIVE
  To avoid a second endoscopy for nasojejunal feeding tube placement (NFTP) in patients undergoing endoscopic nasobiliary drainage (ENBD), we studied improved NFTP method and compared it to endoscopic method.
  
  
  METHODS
  Patients with ENBD were divided into two groups. One group (18 patients) received endoscopic NFTP and the other group (26 patients) received improved NFTP. Placement time, physical condition of the patients and complications were recorded.
  
  
  RESULTS
  In 18 patients who underwent endoscopic NFTP, NFT was successfully placed on the first attempt in 14 patients with a first placement success rate of 77.8%. NFT was wrongly intubated into the trachea in one patient inducing coughing, and after it was removed, the second placement was successful. The total success rate of endoscopic NFTP was 83.3% with an average placement time of 17.0 minutes. In 26 patients undergoing improved NFTP, all were successfully placed on the first attempt with a success rate of 100%, and an average placement time of 2.55 minutes. In patients with ENBD, the success rate of improved NFTP was significantly higher than endoscopic NFTP (χ²=36.4, p<0.05) with a significantly shorter placement time (t=18.5, p<0.05).
  
  
  CONCLUSIONS
  For patients with ENBD, improved NFTP method is superior to the endoscopic method as it is more effective, convenient, faster, and cheaper. Additionally it avoids a second endoscopy and has fewer complications, better security and a higher success rate. The improved method is a safer, easier, more effective and practical method of EN and deserves general adoption in clinical work.
authors.affiliation: Department of Gastroenterology, the Second Affiliated Hospital of Harbin Medical University, 194 Xue Fu Road, Harbin, Heilongjiang Province, 150081, China. drzwl@yahoo.com.cn.
authors.forename: Xin-Hong
authors.initials: XH
authors.lastname: Wang
authors.forename: Zhi-Wu
authors.initials: ZW
authors.lastname: Lv
authors.forename: Bo
authors.initials: B
authors.lastname: Qu
authors.forename: Hui
authors.initials: H
authors.lastname: Xing
authors.forename: Bing
authors.initials: B
authors.lastname: Du
authors.forename: Cheng-Qian
authors.initials: CQ
authors.lastname: Lv
mesh_terms: D000328:Adult; D000368:Aged; D001653:Bile Ducts, Intrahepatic / Q000473:pathology*; D004322:Drainage / Q000379:methods*; D016145:Endoscopy, Digestive System / Q000379:methods*; D004750:Enteral Nutrition / Q000379:methods*; D005260:Female; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome