title: Study of Feeding Jejunostomy as an Add on Procedure in Upper Gastrointestinal Surgeries.
abstract: Jejunostomy is usually indicated as an additional procedure during major surgery of upper digestive tract to administer enteral nutrition in post-operative period. Complications associated with it can be mechanical, infectious, gastrointestinal or metabolic. The aim of the study was to evaluate safety of post-operative feeding jejunostomy in different types of major upper gastrointestinal surgeries. It was a prospective study conducted during the period between August 2009 and September 2011. Post-operative cases of major upper gastrointestinal surgeries who receive jejunostomy feeds were included in the study. Sampling was done by convenient method with sample size of 50 cases. Post-operatively, patients were monitored according to standard orders of enteral nutrition. Total calorie and protein intake through feeding jejunostomy was calculated regularly, and complications were assessed in terms of frequency, type, duration, management, and final outcome in different types of upper gastro intestinal surgeries. Analysis was done using chi square test with the help of statistical package SPSS vers.13. P < 0.05 was considered as significant. Complications observed were gastrointestinal -8 (16 %), mechanical -6 (12 %), infectious -4 (8 %) and metabolic -4 (8 %). Duration of complications ranged from 1 to 7 days (mean, 4 days). All types of complications observed during study were less severe and could be managed by simple measurements. Haemoglobin, serum albumin and weight of the patient at the time of discharge were improved for all patients when compared to pre-operative values. All patients received target calories and proteins through feeding jejunostomy. Considering benefits of enteral feeding via jejunostomy tube with minor and acceptable complications, we conclude that feeding jejunostomy is a preferred route of nutritional administration in those who undergo major upper gastro intestinal surgeries.
authors.affiliation: Department of Surgery, Kasturba Medical College, Manipal University, Mangalore, India.
authors.forename: Jayarama
authors.initials: J
authors.lastname: Shenoy
authors.affiliation: Department of Surgery, Kasturba Medical College, Manipal University, Mangalore, India.
authors.forename: Rajesh Kumar Reddy
authors.initials: RK
authors.lastname: Adapala
keywords: Enteral nutrition; Feeding jejunostomy; Jejunostomy complications; Longitudinal Witzel technique; Post-operative malnutrition; Upper gastrointestinal surgeries