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Clinical experience of feeding through a needle catheter jejunostomy after major abdominal operations
A De Gottardi1, L Krähenbühl, J Farhadi
1Department of Visceral and Transplantation Surgery, University of Bern, Inselspital, Switzerland.
Objective:
To report our incidence of local and systemic complications after needle-catheter jejunostomy.
Design:
Retrospective analysis.
Setting:
University hospital, Switzerland.
Results:
100 patients (70 men and 30 women; mean age 65 years, range 42-90) had needle-catheter jejunostomy for postoperative enteral feeding. 26 developed catheter-related and 18 nutrition-related complications. Most of the complications were minor (lumenal obstruction of the catheter or local cellulitis) and only 3 patients needed reoperation, 2 because the catheter broke with extravasation of the nutrition formula into the subcutaneous tissue, and the other because of a small bowel obstruction. There was no small bowel necrosis and no patient died as a direct result of the jejunostomy. Overall, 92 patients were fed enterally according to the protocol, and 8 required removal of the catheter.
Conclusion:
Needle-catheter jejunostomy gives a safe and effective access for postoperative enteral feeding. Minor technical complications are common and can be reduced by a meticulous insertion technique and careful postoperative management. Regular clinical surveillance may reduce the incidence of nutrition-related complications.