Skip to main content
NCBI home page
The Western Journal of Medicine logoLink to The Western Journal of Medicine
. 1995 Feb;162(2):117–122.

Prospective evaluation of the safety and efficacy of laparoscopic jejunostomy.

Q Y Duh 1, A L Senokozlieff-Englehart 1, A E Siperstein 1, J Pearl 1, J P Grant 1, P L Twomey 1, T R Gadacz 1, R A Prinz 1, B M Wolfe 1, N J Soper 1, et al.
PMCID: PMC1022643  PMID: 7725683

Abstract

We prospectively assessed the safety and efficacy of laparoscopic jejunostomy done by 11 surgeons in 8 medical centers using the T-fastener technique. In all, 23 men and 13 women aged 19 to 84 (mean, 59) years required enteral feeding, but could not undergo gastrostomy and had no contraindication to laparoscopy. Of these patients, 12 had head and neck cancer and 11 had neurologic swallowing dysfunction. The procedure took 25 to 180 minutes (mean, 75). Three (8%) early cases were converted to open jejunostomy because of accidental enterotomies caused by inappropriate techniques that were avoided in later cases. Minor technical problems, such as passing a needle through the back wall of the jejunum, occurred in 7 patients, but they were easily corrected and produced no complications. Feedings were routinely begun within 24 hours of the surgical procedure. All jejunostomy catheters functioned well. This is a safe and effective technique when done by experienced laparoscopic surgeons, and serious complications are rare.

Full text

PDF
117

Images in this article

118Image
on p.118

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Adams D. B. Feeding jejunostomy with endoscopic guidance. Surg Gynecol Obstet. 1991 Mar;172(3):239–241. [PubMed] [Google Scholar]
  2. Albrink M. H., Foster J., Rosemurgy A. S., Carey L. C. Laparoscopic feeding jejunostomy: also a simple technique. Surg Endosc. 1992 Sep-Oct;6(5):259–260. doi: 10.1007/BF02498817. [DOI] [PubMed] [Google Scholar]
  3. Brown A. S., Mueller P. R., Ferrucci J. T., Jr Controlled percutaneous gastrostomy: nylon T-fastener for fixation of the anterior gastric wall. Radiology. 1986 Feb;158(2):543–545. doi: 10.1148/radiology.158.2.2934763. [DOI] [PubMed] [Google Scholar]
  4. Cogen R., Weinryb J., Pomerantz C., Fenstemacher P. Complications of jejunostomy tube feeding in nursing facility patients. Am J Gastroenterol. 1991 Nov;86(11):1610–1613. [PubMed] [Google Scholar]
  5. DiSario J. A., Foutch P. G., Sanowski R. A. Poor results with percutaneous endoscopic jejunostomy. Gastrointest Endosc. 1990 May-Jun;36(3):257–260. doi: 10.1016/s0016-5107(90)71018-8. [DOI] [PubMed] [Google Scholar]
  6. Duh Q. Y., Way L. W. Diagnostic laparoscopy and laparoscopic cecostomy for colonic pseudo-obstruction. Dis Colon Rectum. 1993 Jan;36(1):65–70. doi: 10.1007/BF02050304. [DOI] [PubMed] [Google Scholar]
  7. Duh Q. Y., Way L. W. Laparoscopic gastrostomy using T-fasteners as retractors and anchors. Surg Endosc. 1993 Jan-Feb;7(1):60–63. doi: 10.1007/BF00591241. [DOI] [PubMed] [Google Scholar]
  8. Duh Q. Y., Way L. W. Laparoscopic jejunostomy using T-fasteners as retractors and anchors. Arch Surg. 1993 Jan;128(1):105–108. doi: 10.1001/archsurg.1993.01420130117018. [DOI] [PubMed] [Google Scholar]
  9. Gauderer M. W., Ponsky J. L., Izant R. J., Jr Gastrostomy without laparotomy: a percutaneous endoscopic technique. J Pediatr Surg. 1980 Dec;15(6):872–875. doi: 10.1016/s0022-3468(80)80296-x. [DOI] [PubMed] [Google Scholar]
  10. Jarnagin W. R., Duh Q. Y., Mulvihill S. J., Ridge J. A., Schrock T. R., Way L. W. The efficacy and limitations of percutaneous endoscopic gastrostomy. Arch Surg. 1992 Mar;127(3):261–264. doi: 10.1001/archsurg.1992.01420030023003. [DOI] [PubMed] [Google Scholar]
  11. Kaplan D. S., Murthy U. K., Linscheer W. G. Percutaneous endoscopic jejunostomy: long-term follow-up of 23 patients. Gastrointest Endosc. 1989 Sep-Oct;35(5):403–406. doi: 10.1016/s0016-5107(89)72844-3. [DOI] [PubMed] [Google Scholar]
  12. MacFadyen B. V., Jr, Catalano M. F., Raijman I., Ghobrial R. Percutaneous endoscopic gastrostomy with jejunal extension: a new technique. Am J Gastroenterol. 1992 Jun;87(6):725–728. [PubMed] [Google Scholar]
  13. Morris J. B., Mullen J. L., Yu J. C., Rosato E. F. Laparoscopic-guided jejunostomy. Surgery. 1992 Jul;112(1):96–99. [PubMed] [Google Scholar]
  14. O'Regan P. J., Scarrow G. D. Laparoscopic jejunostomy. Endoscopy. 1990 Jan;22(1):39–40. doi: 10.1055/s-2007-1012785. [DOI] [PubMed] [Google Scholar]
  15. Reed D. N., Jr Percutaneous peritoneoscopic jejunostomy. Surg Gynecol Obstet. 1992 Jun;174(6):527–529. [PubMed] [Google Scholar]
  16. Rosenblum J., Taylor F. C., Lu C. T., Martich V. A new technique for direct percutaneous jejunostomy tube placement. Am J Gastroenterol. 1990 Sep;85(9):1165–1167. [PubMed] [Google Scholar]
  17. Smith-Choban P., Max M. H. Feeding jejunostomy: a small bowel stress test? Am J Surg. 1988 Jan;155(1):112–117. doi: 10.1016/s0002-9610(88)80267-8. [DOI] [PubMed] [Google Scholar]
  18. Wolfsen H. C., Kozarek R. A., Ball T. J., Patterson D. J., Botoman V. A., Ryan J. A. Long-term survival in patients undergoing percutaneous endoscopic gastrostomy and jejunostomy. Am J Gastroenterol. 1990 Sep;85(9):1120–1122. [PubMed] [Google Scholar]

Articles from Western Journal of Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES