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Prophylactic tube jejunostomy: A worthwhile undertaking

Surgery Today volume 38, pages 420–424 (2008)Cite this article

Abstract

Purpose

The status of tube jejunostomy for feeding after major gastrointestinal and pancreatobiliary surgery is being questioned because of concerns about procedure-related complications. This has led to a trend away from performing routine prophylactic tube jejunostomy.

Methods

We retrospectively analyzed 120 consecutive patients who underwent prophylactic tube jejunostomy as part of major gastrointestinal or pancreatobiliary surgery within a 2-year period at a tertiary referral center. The primary end-points were procedure-related morbidity and mortality. We also performed a subset analysis of the duration of enteral feeds and the need for parenteral nutrition (PN) in patients with complications related to the index surgery.

Results

There was no procedure-related mortality or major morbidity. Eight patients (6.7%) required supplementation with PN because enteral feeding failed to achieve the nutritional target. Patients who suffered complications required nutritional support for significantly longer (10.8 days vs 6.4 days; P < 0.001). The nutritional goal of 25 kcal/kg per day was attained with tube jejunostomy feeding in 82 (93%) of 84 patients without complications and in 30 (83%) of 36 patients with complications (P = 0.180).

Conclusions

Prophylactic tube jejunostomy is safe and can be performed with low procedure-related morbidity. When postoperative complications result in delayed or inadequate oral intake, nutritional requirements can be met through tube jejunostomy feeds.

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Affiliations

  1. Department of Surgical Gastroenterology, Sir Ganga Ram Hospital, New Delhi, India

    Anand Ramamurthy, Sanjay Singh Negi & Adarsh Chaudhary

Authors
  1. Anand Ramamurthy
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  2. Sanjay Singh Negi
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  3. Adarsh Chaudhary
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Ramamurthy, A., Negi, S.S. & Chaudhary, A. Prophylactic tube jejunostomy: A worthwhile undertaking. Surg Today 38, 420–424 (2008). https://doi.org/10.1007/s00595-007-3650-1

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  • DOI: https://doi.org/10.1007/s00595-007-3650-1

Key words

  • Enteral feeding
  • Tube jejunostomy
  • Complications