Jejunal conduit urinary diversion

The clinical course of 14 patients undergoing jejunal conduit urinary diversion between 1971 and 1985 is reviewed. Indications for use of jejunum rather than ileum or colon for diversion included radiation changes of the ileum, concurrent colonic neoplasms or injury, concerns about collateral blood supply of the colon and multiple adhesions. There were 2 operative deaths. Followup in the remaining 12 patients was 1 to 116 months (mean 34 months). All of the patients had satisfactory postoperative renal function. Eight patients (67 per cent) experienced a total of 13 complications. Only 3 patients (25 per cent) suffered the electrolyte imbalance characteristic of jejunal conduit syndrome, representing the only complication directly attributable to the use of jejunum. The jejunal conduit is a viable alternative form of urinary diversion in patients in whom the use of other intestinal segments is undesirable because of previous irradiation, surgery or concurrent disease processes. Although jejunal conduits carry an increased risk of electrolyte imbalance, the use of short jejunal loops and prophylactic oral electrolyte replacement therapy can minimize the occurrence of this complication.