Journal of Gastrointestinal Surgery

, Volume 21, Issue 2, pp 259–265 | Cite as

Complications of Feeding Jejunostomy Tubes in Patients with Gastroesophageal Cancer

  • Audrey H. Choi
  • Michael P. O’Leary
  • Shaila J. Merchant
  • Virginia Sun
  • Joseph Chao
  • Dan J. Raz
  • Jae Y. Kim
  • Joseph Kim
Original Article



Feeding jejunostomy tubes (FJT) in patients undergoing resection of gastroesophageal cancers facilitate perioperative nutrition. Data regarding FJT use and complications are limited.

Study design

A single institution review was performed for patients who underwent perioperative FJT placement for gastrectomy or esophagogastrectomy from 2007 to 2015. FJT-related and unrelated complications were evaluated.


FJTs were inserted for total/completion gastrectomy (n = 49/117, 41.9 %), proximal gastrectomy (n = 7/117, 6.0 %), or esophagogastrectomy (n = 61/117, 52.1 %). Ninety percent (n = 106/117) of patients used an FJT at some time point. Although the majority of patients (75.2 %) used FJTs after discharge, 8.5 % (n = 10/117) never used the FJT and 10.3 % (n = 12/117) used the FJT only during hospitalization. Overall, 44.4 % (n = 52/117) had FJT-related complications, including dislodgement (n = 22), clogging (n = 13), and leakage (n = 6). The majority of FJT complications were resolved by telephone triage (13.5 %) or bedside/clinic intervention (57.7 %), but 3.4 % required operative intervention for small bowel obstruction (n = 3) and hemorrhage (n = 1). FJT complications were more common with gastrectomy than esophagogastrectomy (53.6 vs. 36.0 %), perhaps related to longer FJT use in gastrectomy patients (71 vs. 38 days).


FJT-related complications are common, occurring more frequently after gastrectomy than esophagogastrectomy. In most patients, complications can be managed by simple measures, rarely requiring operative intervention. Nevertheless, the need for FJTs should be carefully considered to balance nutritional benefits with the risks of insertion and usage.


Jejunostomy tube Gastric cancer Esophageal cancer Outcomes Complications 



Dr. Chao’s efforts in manuscript preparation were supported by the National Cancer Institute of the National Institutes of Health under award number NIH 5K12CA001727-20. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Authors’ Contributions

JYK and JK contributed to the conception/design of the work; AHC and MPO contributed to the acquisition of data; SJM, VS, JC, and DJR contributed to the analysis/interpretation of data; AHC and MPO drafted the manuscript; all authors critically revised the manuscript for intellectual content; all authors approved the final version submitted and agreed to be accountable for all aspects of the work.

Compliance with Ethical Standards






  1. 1.
    NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines): Gastric Cancer, version 3.2015. National Comprehensive Cancer Network 2015 February 20, 2016]; Available from:
  2. 2.
    NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines): Esophageal and Esophagogastric Junction Cancer, version 3.2015. National Comprehensive Cancer Network 2015 February 20, 2016]; Available from:
  3. 3.
    Nussbaum, D.P., et al., Feeding jejunostomy tube placement in patients undergoing pancreaticoduodenectomy: an ongoing dilemma. J Gastrointest Surg, 2014. 18(10): p. 1752–9.CrossRefPubMedGoogle Scholar
  4. 4.
    Padussis, J.C., et al., Feeding jejunostomy during Whipple is associated with increased morbidity. J Surg Res, 2014. 187(2): p. 361–6.CrossRefPubMedGoogle Scholar
  5. 5.
    Dann, G.C., et al., An assessment of feeding jejunostomy tube placement at the time of resection for gastric adenocarcinoma: A seven-institution analysis of 837 patients from the U.S. gastric cancer collaborative. J Surg Oncol, 2015. 112(2): p.195–202.Google Scholar
  6. 6.
    Sun, Z., Shenoi, M.M., Nussbaum D.P., et al., Feeding jejunostomy tube placement during resection of gastric cancers. J Surg Res, 2016. 200(1): p. 189–94.Google Scholar
  7. 7.
    Dindo, D., N. Demartines, and P.A. Clavien, Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg, 2004. 240(2): p. 205–13.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Han-Geurts, I.J., et al., Randomized clinical trial comparing feeding jejunostomy with nasoduodenal tube placement in patients undergoing oesophagectomy. Br J Surg, 2007. 94(1): p. 31–5.CrossRefPubMedGoogle Scholar
  9. 9.
    Page, R.D., et al., Intravenous hydration versus naso-jejunal enteral feeding after esophagectomy: a randomised study. Eur J Cardiothorac Surg, 2002. 22(5): p. 666–72.CrossRefPubMedGoogle Scholar
  10. 10.
    Swails W.S., B.T.J., Ellis F.H., Kenler A.S., Forse R.A., The role of enteral jejunostomy feeding after esophagogastrectomy: a prospective, randomized study. Dis Esophagus, 1985. 8: p. 193–199.Google Scholar
  11. 11.
    Wheble, G.A., R.A. Benson, and O.A. Khan, Is routine postoperative enteral feeding after oesophagectomy worthwhile? Interact Cardiovasc Thorac Surg, 2012. 15(4): p. 709–12.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Gupta, V., Benefits versus risks: a prospective audit. Feeding jejunostomy during esophagectomy. World J Surg, 2009. 33(7): p. 1432–8.CrossRefPubMedGoogle Scholar
  13. 13.
    Jenkinson, A.D., et al., Laparoscopic feeding jejunostomy in esophagogastric cancer. Surg Endosc, 2007. 21(2): p. 299–302.CrossRefPubMedGoogle Scholar
  14. 14.
    Fenton, J.R., et al., Feeding jejunostomy tubes placed during esophagectomy: are they necessary? Ann Thorac Surg, 2011. 92(2): p. 504–11; discussion 511–2.CrossRefPubMedGoogle Scholar
  15. 15.
    Srinathan, S.K., et al., Jejunostomy tube feeding in patients undergoing esophagectomy. Can J Surg, 2013. 56(6): p. 409–14.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Patel, S.H., et al., An assessment of feeding jejunostomy tube placement at the time of resection for gastric adenocarcinoma. J Surg Oncol, 2013. 107(7): p. 728–34.CrossRefPubMedGoogle Scholar

Copyright information

© The Society for Surgery of the Alimentary Tract 2016

Authors and Affiliations

  • Audrey H. Choi
    • 1
  • Michael P. O’Leary
    • 1
  • Shaila J. Merchant
    • 2
  • Virginia Sun
    • 3
  • Joseph Chao
    • 4
  • Dan J. Raz
    • 1
  • Jae Y. Kim
    • 1
  • Joseph Kim
    • 5
  1. 1.Department of SurgeryCity of HopeDuarteUSA
  2. 2.Department of SurgeryQueen’s UniversityKingstonCanada
  3. 3.Division of Nursing Research and EducationCity of HopeDuarteUSA
  4. 4.Department of Medical OncologyCity of HopeDuarteUSA
  5. 5.Department of SurgerySUNY Stony BrookStony BrookUSA

Personalised recommendations