1. Utility of feeding jejunostomy tubes in pancreaticoduodenectomy
- Author
-
Hussein E. Waliye, G. Paul Wright, Jared Johnson, Caitlin McCarthy, Andrea M. Wolf, Alex Scales, and Mathew H. Chung
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,Jejunostomy ,Preoperative nutrition ,Pancreaticoduodenectomy ,Cohort Studies ,Eating ,03 medical and health sciences ,Enteral Nutrition ,0302 clinical medicine ,Risk Factors ,Chart review ,Humans ,Medicine ,Feeding tube ,Aged ,Retrospective Studies ,Jejunostomy tubes ,Gastric emptying ,business.industry ,General surgery ,Outcome measures ,General Medicine ,Length of Stay ,Middle Aged ,Surgery ,Gastric Emptying ,030220 oncology & carcinogenesis ,Female ,030211 gastroenterology & hepatology ,business ,Feeding jejunostomy - Abstract
Routine placement of jejunostomy tubes (JT) during pancreaticoduodenectomy (PD) is controversial.A retrospective chart review of patients undergoing PD from 1/1/08 through 12/31/14 was performed. The patients were divided into groups by placement of JT. Outcome measures were 90-day morbidity, 90-day mortality, length of stay, rate of delayed gastric emptying (DGE), and JT-specific complications.256 patients were included. There were no significant differences in 90-day morbidity (39.9% vs. 37.9%, p = 0.747), 90-day mortality (3.9% vs. 1.0%, p = 0.247) or TPN use (24.8 vs. 25.2%, p = 0.941) between those with and without JT, respectively. Patients with a JT had a higher rate of DGE (p 0.001), longer hospital stay (14.3 vs. 11.6, p 0.001), and longer time to solid intake (9.4 vs. 7.3, p 0.001). Eleven patients (7.2%) with JT had tube-related morbidity.Routine placement of JT at the time of PD should be abandoned with efforts focused on preoperative nutrition optimization and early oral diet trials.
- Published
- 2017
- Full Text
- View/download PDF