Needle-catheter jejunostomy for postoperative nutritional support.

Use of the needle-catheter feeding jejunostomy at Richland Memorial Hospital and the Dorn Veterans Administration Hospital, both clinical teaching institutions of the University of South Carolina School of Medicine, has been evaluated in 114 patients ranging from 20 to 90 years old. The results of this survey span a 36-month period, from Jan 1, 1982 to Jan 1, 1985, in which jejunostomy catheters were inserted via a subserosal approach to provide early postoperative enteral support after elective and emergency surgical procedures. Of the 114 patients who had the catheter inserted, 82 (72%) completed a course of enteral tube feedings without complications, whereas 32 (28%) had either mechanical or metabolic complications leading to temporary or permanent cessation of feeding. One patient had a serious midjejunal volvulus, resulting in extensive jejunal necrosis and subsequent resection, a heretofore unpublished complication of this technique. The median number of days with catheter per patient was 18, with a range of one to 98 days. Only four (3.5%) of the catheters inserted were not used. Nutritional parameters were maintained or improved in all patients reviewed. The results of this study encourage the insertion of a feeding jejunostomy catheter as a complementary surgical procedure in patients expected to have a catabolic postoperative course, and who are therefore in need of aggressive nutritional support.