Fluoroscopically guided percutaneous jejunostomy: outcomes in 25 consecutive patients

Yang, Z.Q.; Shin, J.H.; Song, H.-Y.; Kwon, J.H.; Kim, J.-W.; Kim, K.R.; Kim, J.-H.

doi:10.1016/j.crad.2007.02.023

« Previous Next »Clinical Radiology
Volume 62, Issue 11 , Pages 1061-1065, November 2007

Fluoroscopically guided percutaneous jejunostomy: outcomes in 25 consecutive patients

Z.Q. Yang
- Department of Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, P. R. China
J.H. Shin
- Departments of Radiology and Research Institute of Radiology, Asan Medical Centre, University of Ulsan College of Medicine, Poongnap-2dong, Songpa-gu, Seoul, Republic of Korea
- Guarantor and correspondent: J.H. Shin, Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap-2dong, Songpa-gu, Seoul, 138-736, Republic of Korea. Tel.: +82 2 3010 4380; fax: +82 2 476 0090.
H.-Y. Song
- Departments of Radiology and Research Institute of Radiology, Asan Medical Centre, University of Ulsan College of Medicine, Poongnap-2dong, Songpa-gu, Seoul, Republic of Korea
J.H. Kwon
- Departments of Radiology and Research Institute of Radiology, Asan Medical Centre, University of Ulsan College of Medicine, Poongnap-2dong, Songpa-gu, Seoul, Republic of Korea
J.-W. Kim
- Departments of Radiology and Research Institute of Radiology, Asan Medical Centre, University of Ulsan College of Medicine, Poongnap-2dong, Songpa-gu, Seoul, Republic of Korea
K.R. Kim
- Departments of Radiology and Research Institute of Radiology, Asan Medical Centre, University of Ulsan College of Medicine, Poongnap-2dong, Songpa-gu, Seoul, Republic of Korea
J.-H. Kim
- Departments of Radiology and Research Institute of Radiology, Asan Medical Centre, University of Ulsan College of Medicine, Poongnap-2dong, Songpa-gu, Seoul, Republic of Korea

Received 23 November 2006; received in revised form 17 January 2007; accepted 24 February 2007.

Aim

To assess the feasibility and safety of fluoroscopically guided percutaneous jejunostomy.

Material and methods

Between May 1999 and August 2006 percutaneous jejunostomy was attempted in 25 patients. A 5 F vascular catheter (n=20) or a 7.5 F multifunctional coil catheter (n=5) was used to insufflate the jejunum. The distended jejunum was punctured using a 17 G needle (n=19) or a 21 G Chiba needle (n=6) with the inserted catheter as a target. A 12 or 14 F loop feeding tube was inserted after serial dilations. The technical success, complications, 30-day mortality, and in-dwelling period of the feeding tube placement were evaluated.

Results

The technical success rate was 92% (23/25). Technical failures (n=2) resulted from the inability to insufflate the jejunum secondary to failure to pass the catheter through a malignant stricture at the oesophagojejunostomy site and thus subsequent puncture of the undistended jejunum failed, or failure to introduce the Neff catheter into the jejunum. Pericatheter leakage with pneumoperitoneum was a complication in three patients (12%) and was treated conservatively. The 30-day mortality was 13% (3/23); however, there was no evidence that these deaths were attributed to the procedure. Except for four patients who were lost to follow-up and two failed cases, 15 of the 19 jejunostomy catheters were removed because of patient death (n=12) or completion of treatment (n=3), with a mean and median in-dwelling period of 231 and 87 days, respectively.

Conclusions

Fluoroscopically guided percutaneous jejunostomy is a feasible procedure with a high technical success and a low complication rate. In addition to a 17 G needle, a 21 G needle can safely be used to puncture the jejunum.