A multicenter, prospective study of the placement of transpyloric feeding tubes with assistance of a magnetic device

Background: Placement of feeding tubes in the transpyloric position can be helpful in the management of enterally fed patients with pancreatitis, gast ric atony, enterocutaneous fistulae, or pulmonary aspiration risk. The atta inment of transpyloric position is difficult, and numerous techniques have been proposed to help in achieving this location. Recently, the use of a ma gnet-tipped feeding tube, dragged into proper position with an external mag net, has been described with an excellent success rate. Methods: At 10 part icipating institutions, practitioners were trained in the use of the device . Successful tube placement was determined by abdominal radiograph. Results . One hundred fifty-six tube placements were attempted. Transpyloric positi on was obtained in 60%. Placement into the third portion of the duodenum or distal was obtained in only 32%. Analysis of the data did not reveal a lea rning curve at the institutions, and 7 of 10 had a 50% or lower success rat s. Conclusions: Placement of feeding tubes with the assistance of a magneti c device was infrequently successful at the majority of institutions where it was attempted. We report a lower success rate than the original article, which described an 88% success rate of transpyloric intubation, Although t his technique has a high failure rate, some individuals seem to be very suc cessful using it, which could reduce the need for endoscopy or transport fo r the placement of feeding tubes.