title: Utility of feeding jejunostomy tubes in pancreaticoduodenectomy.
abstract: BACKGROUND
  Routine placement of jejunostomy tubes (JT) during pancreaticoduodenectomy (PD) is controversial.
  
  
  METHODS
  A retrospective chart review of patients undergoing PD from 1/1/08 through 12/31/14 was performed. The patients were divided into groups by placement of JT. Outcome measures were 90-day morbidity, 90-day mortality, length of stay, rate of delayed gastric emptying (DGE), and JT-specific complications.
  
  
  RESULTS
  256 patients were included. There were no significant differences in 90-day morbidity (39.9% vs. 37.9%, p = 0.747), 90-day mortality (3.9% vs. 1.0%, p = 0.247) or TPN use (24.8 vs. 25.2%, p = 0.941) between those with and without JT, respectively. Patients with a JT had a higher rate of DGE (p < 0.001), longer hospital stay (14.3 vs. 11.6, p < 0.001), and longer time to solid intake (9.4 vs. 7.3, p < 0.001). Eleven patients (7.2%) with JT had tube-related morbidity.
  
  
  CONCLUSIONS
  Routine placement of JT at the time of PD should be abandoned with efforts focused on preoperative nutrition optimization and early oral diet trials.
authors.affiliation: Grand Rapids Medical Education Partners, General Surgery Residency Program, Grand Rapids, MI, United States; Department of Surgery, Michigan State University College of Human Medicine, Grand Rapids, MI, United States. Electronic address: Hussein.waliye@grmep.com.
authors.forename: Hussein E
authors.initials: HE
authors.lastname: Waliye
authors.affiliation: Grand Rapids Medical Education Partners, General Surgery Residency Program, Grand Rapids, MI, United States; Department of Surgery, Michigan State University College of Human Medicine, Grand Rapids, MI, United States.
authors.forename: G Paul
authors.initials: GP
authors.lastname: Wright
authors.affiliation: Department of Surgery, Michigan State University College of Human Medicine, Grand Rapids, MI, United States.
authors.forename: Caitlin
authors.initials: C
authors.lastname: McCarthy
authors.affiliation: Department of Surgery, Michigan State University College of Human Medicine, Grand Rapids, MI, United States.
authors.forename: Jared
authors.initials: J
authors.lastname: Johnson
authors.affiliation: Department of Surgery, Michigan State University College of Human Medicine, Grand Rapids, MI, United States.
authors.forename: Alex
authors.initials: A
authors.lastname: Scales
authors.affiliation: Grand Rapids Medical Education Partners, General Surgery Residency Program, Grand Rapids, MI, United States; Department of Surgery, Michigan State University College of Human Medicine, Grand Rapids, MI, United States; Division of Surgical Oncology, Spectrum Health Medical Group, Grand Rapids, MI, United States.
authors.forename: Andrea
authors.initials: A
authors.lastname: Wolf
authors.affiliation: Grand Rapids Medical Education Partners, General Surgery Residency Program, Grand Rapids, MI, United States; Department of Surgery, Michigan State University College of Human Medicine, Grand Rapids, MI, United States; Division of Surgical Oncology, Spectrum Health Medical Group, Grand Rapids, MI, United States. Electronic address: Mathew.Chung@spectrumhealth.org.
authors.forename: Mathew
authors.initials: M
authors.lastname: Chung
mesh_terms: D000368:Aged; D015331:Cohort Studies; D004435:Eating; D004750:Enteral Nutrition / Q000009:adverse effects*; D005260:Female; D005746:Gastric Emptying; D006801:Humans; D007582:Jejunostomy / Q000009:adverse effects*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D016577:Pancreaticoduodenectomy; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors
keywords: Feeding jejunostomy tube; Feeding tube; Pancreaticoduodenectomy; Whipple