Efficient gastroduodenal decompression with simultaneous full enteral nutrition: a new gastrostomy catheter technique

A gastrostomy tube was designed that provides efficient supplemental aspiration of the proximal duodenum to remove gas that escapes gastric removal, utilizing an extension of the gastric suction channel. A separate lumen delivers elemental diet 7.5 cm more distally, for safe postoperative feeding. On clinical testing, patients consistently achieved immediately postoperative enteral absorption of 3000 kcal/day and positive protein balance. Supplemental insulin was required for optimum utilization, maintaining plasma glucose within the physiologic range. Oral barium motility study during the second 24 hr demonstrated prompt gastric emptying and spontaneous anastomotic passage. We noted decreased clogging with mucus, attributable to "self-cleansing" by the aspirated duodenal juices. This was returned with the feedings to prevent depletion. There were no complications attributable to this regimen. Patients were discharged uneventfully as early as 48 hr following colectomy.