PROSPECTIVE EVALUATION OF THE SAFETY AND EFFICACY OF LAPAROSCOPIC JEJUNOSTOMY

We prospectively assessed the safety and efficacy of laparoscopic jeju nostomy 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 n eck cancer and 11 had neurologic swallowing dysfunction. The procedure took 25 to 180 minutes (mean, 75). Three (8%) early cases were conver ted to open jejunostomy because of accidental enterotomies caused by i nappropriate techniques that were avoided in later cases. Minor techni cal problems, such as passing a needle through the back wall of the je junum, occurred in 7 patients, but they were easily corrected and prod uced no complications. Feedings were routinely begun within 24 hours o f the surgical procedure. All jejunostomy catheters functioned well. T his is a safe and effective technique when done by experienced laparos copic surgeons, and serious complications are rare.