Purpose: To determine if design modifications to the Gray-St. Louis gastrojejunostomy catheter would improve its deployment and utilization characteristics.
Methods: A modified catheter and the Gray-St. Louis catheter were alternately inserted in consecutive patients requiring gastrojejunostomy. At the time of insertion, the anatomic locations of the fenestrated end of the catheter and the Cope retention loop were recorded. At the time of removal or exchange, catheters were assessed for the position of the fenestrated end and the retention loop, the presence of catheter tears, leakage of injected contrast medium and evidence of catheter blockage.
Results: Of the 250 catheters we assessed in a 3-year period, 141 (56%) were modified catheters and 109 (44%) were Gray-St. Louis catheters. At insertion, the retention loop of the modified catheter was in the duodenum in 132 (94%) patients, whereas the retention loop of the Gray-St. Louis Catheter reached the duodenum in 29 (27%) (p < 0.05). At the time of catheter removal or exchange, the retention loop of the modified catheter was in the duodenum in 72 (60%) patients, whereas the retention loop of the Gray-St. Louis catheter was in the duodenum in 13 (14%) (p < 0.05).
Conclusion: The design modifications to the Gray-St. Louis catheter improved the likelihood of the retention loop residing in the duodenum, while continuing to allow the fenestrated portion of the catheter to reside in the jejunum.