DIRECT PERCUTANEOUS JEJUNOSTOMY

PURPOSE: Enteral feeding via gastrostomy or gastrojejunostomy tubes has an established role in patients unable to maintain adequate oral intake. However, creation and maintenance of a site for long-term nutritional support can be significant problems in patients who have undergone previous surgery or in patients with chronic aspiration, abnormal stomach position, or recurrent inadvertent tube dislodgment. Direct percutaneous jejunostomy (DPJ) tube placement performed with fluoroscopic guidance was evaluated in these patients. PATIENTS AND METHODS: Fourteen DPJ tube placements for enteral feeding were attempted in 13 patients with use of local anesthesia, fluoroscopic guidance, the Seldinger technique, and jejunopexy. There were nine male and four female patients with a mean age of 75.2 years (range, 45-95 years). RESULTS: DPJ was successful in 11 of 13 patients. A mean follow-up of 58.9 days (range, 3-291 days) was obtained in all 11 patients. CONCLUSIONS: DPJ is a safe and viable alternative for the creation and maintenance of long-term enteral tube feeding, particularly in patients with underlying esophagogastric malignancy, recurrent inadvertent tube dislodgment, or previous gastric surgery.