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Gastrojejunostomy tube complications - A single center experience and systematic review

James Morse1, Robert Baird1, Karl Muchantef2

  • 1Divisions of Pediatric General and Thoracic Surgery, The Montreal Children's Hospital of the McGill University Health Centre, Montreal, Quebec, Canada.

Journal of Pediatric Surgery
|February 7, 2017
PubMed

Insights

Gastrojejunostomy tubes (GJTs) are linked to serious complications, especially in infants under 10kg. These tubes require frequent revisions, and perforation risk is significantly higher in smaller children.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Medical Devices

Background:

  • Gastrojejunostomy tubes (GJTs) are crucial for enteral nutrition in pediatric patients with feeding intolerance.
  • Complications associated with GJTs may be more prevalent in younger and smaller infants.

Purpose of the Study:

  • To evaluate the complication rate of gastrojejunostomy tube (GJT) placements at a single institution.
  • To systematically review existing literature on GJT complications, focusing on perforation and mortality rates.

Main Methods:

  • Retrospective analysis of GJT placements from 2009-2015 at a single institution.
  • Systematic literature review following MOOSE guidelines, assessing 48 articles on 2726 procedures.

Main Results:

  • At the institution, 48 children underwent 154 successful GJT insertions, primarily for reflux and aspiration.
  • Systematic review estimated an overall GJT perforation rate of 2.1%, with significantly higher rates in children <10kg (3.1%) versus ≥10kg (0.1%).
  • Overall mortality was estimated at 0.9%, with most perforations occurring within 30 days of placement.

Conclusions:

  • Gastrojejunostomy tubes are associated with substantial complications and often necessitate revision or replacement.
  • GJT insertion in pediatric patients weighing less than 10kg carries an elevated risk of perforation, warranting caution.
Abstract

Keywords:
ComplicationGastrojejunostomy tubeInfantPediatricPerforation

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