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Laparoscopic percutaneous jejunostomy for long term enteral access
M Hotokezaka1, R B Adams, A D Miller
1Department of Surgery, University of Virginia Health Sciences Center, Charlottesville, VA 22908, USA.
Surgical Endoscopy
|October 1, 1996
Summary
Laparoscopic jejunostomy provides safe and minimally invasive jejunal feeding access for patients with upper gastrointestinal issues. Previous abdominal surgery does not preclude this effective nutritional support method.
Area of Science:
- Minimally Invasive Surgery
- Gastroenterology
- Surgical Nutrition
Background:
- Upper gastrointestinal pathology often necessitates jejunal feeding for nutritional support.
- Percutaneous jejunostomy guided by laparoscopy is a minimally invasive option for enteral access.
Purpose of the Study:
- To evaluate the safety and efficacy of laparoscopic jejunostomy for nutritional support.
- To identify factors influencing the success and complications of the procedure.
Main Methods:
- Laparoscopic jejunostomy was performed in 32 patients, with common indications including gastroparesis, neurological deficits, and proximal obstruction.
- The proximal jejunum was secured to the abdominal wall, facilitating the insertion of a dual-lumen feeding tube.
Main Results:
- The procedure was successfully completed in 28 patients, with four conversions to open surgery, particularly in those with prior abdominal surgery.
- Major complications occurred in seven patients, including one reoperation and one death from aspiration pneumonia.
- All patients achieved tube feeding, with 20 progressing to full enteral nutrition without interruption.
Conclusions:
- Laparoscopic jejunostomy is a relatively safe procedure for jejunal feeding.
- Morbidity is often associated with pre-existing conditions, not the laparoscopic approach itself.
- A history of abdominal surgery is not an absolute contraindication for laparoscopic jejunostomy.