Feeding jejunostomy during Whipple is associated with increased morbidity

Area of Science:

• Gastroenterology
• Surgical Oncology
• Clinical Outcomes Research

Background:

• Feeding jejunostomy (FJ) tube placement is common during pancreaticoduodenectomy (PD).
• Limited research exists on the impact of FJ placement on PD outcomes.

Purpose of the Study:

• To investigate the association between FJ placement during PD and 30-day postoperative outcomes.
• To compare mortality, major, and overall complication rates between patients with and without FJ placement.

Main Methods:

• Retrospective analysis of the National Surgical Quality Improvement Program (NSQIP) database.
• Inclusion of 4930 patients who underwent PD.
• Univariate and multivariate comparisons of outcomes based on FJ placement.

Main Results:

• No significant difference in 30-day mortality between groups (4.0% with FJ vs. 2.7% without).
• Significantly higher overall morbidity (43.3% vs. 34.6%) and serious morbidity (29.5% vs. 22.8%) in patients with FJ placement.
• Increased incidence of deep surgical site infections, pneumonia, reintubation, acute renal failure, and sepsis in FJ patients.

Conclusions:

• FJ placement during PD, while routine, is associated with increased postoperative morbidity.
• The findings suggest a need to re-evaluate the routine use of FJ tubes during PD.
• Further research may explore alternative feeding strategies or patient selection criteria.