BILIARY SLUDGE FORMATION DURING ENTERAL NUTRITION - PREVALENCE AND NATURAL-HISTORY

Background. Total parenteral nutrition is an etiologic factor in the f ormation of biliary sludge. We stud led whether enteral nutrition is a lso a risk factor for sludge. Methods. Fifty patients with a needle ca theter jejunostomy (NCJ) placed during a major abdominal operation und erwent preoperative and weekly postoperative ultrasonography until NCJ feedings were discontinued (1 to 6 weeks). Results. All patients were men. The mean age was 63.2 +/- 1.6 years. Fourteen asymptomatic patie nts (28.0%) had biliary sludge within 2 weeks of beg-inning enteral fe edings through a NCJ. Complete ultrasonographic resolution of sludge w as observed in 13 of the 14 positive patients within 1 to 2 weeks of r esuming an oral diet. One patient was lost to follow-up after 14 week; a positive sonogram had persisted but the patient remained asymptomat ic. During the period of observation, no other patient had signs of bi liary tract disease. Conclusions. (1) Biliary sludge may form in some patients during enteral feeding with NCJ. (2) Sludge is cleared by the gallbladder once nit oral diet is resumed. (3) There appears to be li ttle risk of complications during postoperative enteral feeding.