[Direct percutaneous radiologic jejunostomy (PR) and duodenostomy: a retrospective analysis]

Area of Science:

• Interventional Radiology
• Gastroenterology
• Surgical Nutrition

Background:

• Percutaneous feeding tube placement is crucial for nutritional support in patients unable to eat orally.
• Direct percutaneous radiologic duodenostomy and jejunostomy (PRJ) offer minimally invasive alimentation options.

Purpose of the Study:

• To evaluate the safety and efficacy of direct percutaneous radiologic duodenostomy and jejunostomy (PRJ) for patient alimentation.
• To present our institutional experience with PRJ over a nine-year period.

Main Methods:

• Retrospective review of 24 patients undergoing CT- and fluoroscopy-guided PRJ.
• Procedures included jejunostomy and duodenostomy, with variations in imaging guidance (fluoroscopy alone, or CT/fluoroscopy combination).
• Technical success, complications, and patient outcomes were assessed.

Main Results:

• PRJ demonstrated a high technical success rate, particularly when guided solely by fluoroscopy (8/8) and for duodenostomy (7/7).
• CT/fluoroscopy guided jejunostomy had a success rate of 4/9.
• No procedure-related laparotomies or mortality were observed; minor complications included infection, pain, and aspiration.

Conclusions:

• PRJ is a safe and effective method for prolonged alimentation, even in critically ill patients.
• Technical difficulty can arise if jejunal distension is not achieved.
• PRJ is recommended for malnourished patients, particularly post-esophageal or gastric surgery.