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Characterizing Trends in Preoperative Workup and Evaluation for Pediatric Patients Needing Gastrojejunostomy Tube

Sage A Vincent1, Emily Meneses2, Alexandra Barone-Camp3

  • 1Division of Pediatric Surgery, Children's Hospital Colorado, Anschutz Medical Campus, Aurora, Colorado, USA.

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
|May 13, 2026
PubMed

Insights

Pediatric gastrojejunostomy tube (GJT) placement shows varied referral and workup patterns. Many patients require alternative enteral access within four years, highlighting the need for standardized evaluation.

Area of Science:

  • Pediatric Gastroenterology
  • Surgical Procedures
  • Medical Device Placement

Background:

  • Gastrojejunostomy tube (GJT) placement is crucial for pediatric patients with complex feeding needs.
  • Standard preoperative evaluations exist for gastrostomy tubes (GT), but GJT workup and referral patterns are less defined.

Purpose of the Study:

  • To investigate the preoperative workup and referral patterns for pediatric gastrojejunostomy tube (GJT) placement.
  • To assess long-term enteral access outcomes following GJT placement in pediatric patients.

Main Methods:

  • Retrospective cohort study of 90 pediatric patients undergoing GJT placement (2014-2024).
  • Included primary GJT (pGJT) and staged GJT (sGJT) patients, analyzing preoperative workup and referral sources.
  • Categorized sGJT into planned and delayed cohorts based on timing of GJT exchange after GT placement.

Main Results:

  • Referrals primarily came from gastroenterology (45.6%) and intensivists (21.1%).
  • Common preoperative evaluations included upper GI fluoroscopic swallow study (60.0%) and transpyloric feeding trials (55.6%).
  • High GJT utilization persisted at 1 year (92.2%), but decreased to 62.2% at median 4-year follow-up, with ~40% requiring alternative access.

Conclusions:

  • Pediatric GJT placement exhibits heterogeneous referral and preoperative workup processes.
  • A significant proportion of pediatric patients require alternative enteral access methods within four years post-GJT placement.
  • Standardization of preoperative evaluation and workflow for pediatric GJT placement is recommended.
Abstract

Keywords:
GJTenteral accessgastrojejunostomy tubepreoperative evaluationworkup

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