Association of preoperative chyme reinfusion via percutaneous endoscopic colostomy with post-reversal Fluid independence in short bowel syndrome patients with an end jejunostomy and an intact but defunctionalized colon.

BACKGROUND AND AIMS: In patients with short bowel syndrome (SBS) with an end jejunostomy and an intact but defunctionalized colon, whether preoperative chyme reinfusion via percutaneous endoscopic colostomy (PEC) improves long-term outcomes after stoma reversal remains unclear.

METHODS

This retrospective study included 71 SBS patients with an end jejunostomy and an intact colon who underwent stoma reversal (2019-2024). Fifty-seven received PEC with chyme reinfusion; 14 received conventional care. The primary outcome was weaning from intravenous fluid replacement after stoma reversal.

RESULTS

Median follow-up was 19 months. PEC placement independently predicted successful fluid weaning after reversal (HR = 1.97; P = 0.026). Among PEC patients, residual bowel length ≥100 cm was the only predictor (HR = 1.99; P = 0.025). During preoperative treatment, PEC patients required significantly less fluid replacement (difference = 851.6 mL, P < 0.001) and electrolyte supplementation. Post-reversal PN weaning rates were comparably high (97.2% overall). PEC-related complications occurred in 4 patients (7.0%), all minor.

CONCLUSION

Preoperative PEC with chyme reinfusion appears safe and may be associated with improved post-reversal fluid independence in SBS patients with an end jejunostomy and an intact but defunctionalized colon, particularly those with residual bowel length ≥100 cm.