US and fluoroscopic-guided percutaneous jejunostomy: Experience in 49 patients

PURPOSE: To assess the feasibility and safety of a variety of techniques fo r percutaneous jejunostomy, MATERIALS AND METHODS: Percutaneous jejunostomy was at tempted on 53 occasi ons in 49 patients under US and fluoroscopic guidance. During the study per iod, thicker needles, Cope anchors, and intravenous glucagon were introduce d to improve access, dilate, and immobilize the jejunum, Technical success rates, complications, catheterization period, and reasons for catheter remo val were prospectively studied, Prognostic factors for successful procedure s and complications were determined, RESULTS: Forty-six (87%) procedures were technically successful. Previous g astrointestinal surgery (P = .01) and a combination of thicker needles, Cop e anchors, and intravenous glucagon (P = .0001) were associated with a high er technical success rate. Complications (n = 6; pericatheter leakage in fo ur of six) were observed more frequently in older patients (P = .01), The 3 0-day mortality rate was 17%, one death may have been procedure related, Fo rty-three catheters were removed (elective, n = 36; other, n = 7) after 1-5 97 days (median, 49), Three catheters remained in situ for 139-482 days (me dian, 410). CONCLUSIONS: Percutaneous jejunostomy is a feasible and relatively safe tec hnique for long-term feeding. Leakage is the main problem, which warrants a dditional study.