DIRECT PERCUTANEOUS JEJUNOSTOMY - TECHNIQUES AND APPLICATIONS - 10 YEARS EXPERIENCE

PURPOSE: To present 10 years experience with direct fluoroscopically g uided percutaneous jejunostomy. MATERIALS AND METHODS: Percutaneous je junostomy was performed in 62 patients, most of whom had undergone maj or abdominal surgery. A new or replacement jejunostomy was created for alimentation in 20 and 21 patients, respectively. Jejunostomy war per formed for interventional procedures oi the bile ducts or intestine in 13 patients and for retrograde gastroesophageal drainage in eight. Th e distended jejunum was accessed with a 21-gauge needle, immobilized w ith a gastric anchor, and catheterized with a 10-14-F locking loop RES ULTS: The technical success rate was 19 of 20 (95%) for new feeding je junostomy and 17 of 21 (81%) for replacement feeding jejunostomy. Jeju nostomy facilitated drainage, dilation, stone extraction, and recanali zation in the bile ducts or intestine in all 13 patients. Retrograde j ejunoesophagogastrostomy suction effectively replaced painful nasogast ric suction in all eight patients. Two patients who underwent replacem ent jejunostomy required laparotomy for possible leakage; ere was no i mportant procedure-related morbidity and no procedure-related CONCLUSI ON: The technical success and complication rates of feeding percutaneo us jejunostomy compare favorably with those of surgery or endoscopy. P ercutaneous jejunostomy is a useful and underused approach to managing bowel and biliary obstruction.