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Complication Rates and Variability in Gastrojejunostomy Tube Usage in Infants and Children

Oliver S Zhao1, Maren E Shipe2, Melissa E Danko3

  • 1Vanderbilt University School of Medicine, Nashville, TN, USA.

Journal of Pediatric Surgery
|November 16, 2024
PubMed

Insights

Gastrojejunostomy tube (GJT) placement complication rates were similar in infants and older children. African American children and those undergoing urgent procedures had higher complication risks, indicating age is not a contraindication for GJT placement.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Health Services Research

Background:

  • Gastrojejunostomy tubes (GJT) are crucial for enteral access in children with feeding intolerance.
  • Previous research suggested higher complication risks for infants undergoing GJT placement compared to older children.
  • This study investigates GJT usage and associated postoperative complications in children using national databases.

Purpose of the Study:

  • To characterize gastrojejunostomy tube (GJT) usage in pediatric patients.
  • To identify risk factors for postoperative complications following GJT placement in children.
  • To compare complication rates between infants and non-infants undergoing GJT placement.

Main Methods:

  • Retrospective cohort study utilizing the Pediatric American College of Surgeons National Surgical Quality Improvement Program (Ped-NSQIP) and Pediatric Health Information System (PHIS) databases.
  • Comparison of complication rates between infants (<1 year) and non-infants (≥1 year) within each database.
  • Multivariable logistic regression analysis to identify predictors of postoperative complications.

Main Results:

  • Infants did not show an increased rate of surgical complications compared to non-infants in either database (Ped-NSQIP: 26.9% vs. 29.0%; PHIS: 35.3% vs. 30.7%).
  • Increased complication risk was observed in African American children (infants and non-infants) and for urgent/emergent procedures in both age groups.
  • Significant institutional variation in GJT placement and complication rates was noted.

Conclusions:

  • Overall complication rates for gastrojejunostomy tube (GJT) placement are substantial but similar between infants and non-infants.
  • Postoperative complication risks are associated with race and procedure urgency, not solely with age.
  • GJT placement should be considered when indicated for enteral access in children, irrespective of age.
Abstract

Keywords:
GERDGJ tubesGastroesophageal refluxGastrojejunostomy tube

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