COMPLICATIONS OF NEEDLE CATHETER JEJUNOSTOMY IN 2,022 CONSECUTIVE APPLICATIONS

BACKGROUND: We commonly use needle catheter jejunostomy (NCJ) for earl y enteral feeding in selected patients, Review of our approach was pro mpted by the suggestion that enteral feeding represents a ''stress tes t'' for the bowel and may be associated with a high complication rate. MATERIALS AND METHODS: We r eviewed patients with NCJ inserted over t he past 16 years by prospective database, chart review, and conference minutes, with emphasis on complications. RESULTS: During the conduct of 28,121 laparotomies, 2,022 NCJs inserted in 1,938 patients (7.2%) r esulted in 34 NCJ-related complications in 29 patients (1.5%) The most common complication was premature loss of the catheter from occlusion or dislodgment (n = 15; 0.74%), and the most serious was bowel necros is (n = 3; 0.15%). CONCLUSIONS: Needle catheter jejunostomy may be ins erted and used with a low complication rate. Most complications were p reventable through greater attention to detail and better monitoring o f physical examination of patients with marginal gut function.