Feasibility and safety of needle catheter jejunostomy for enteral nutrition in surgically treated severe acute pancreatitis

JPEN J Parenter Enteral Nutr. 2004 Sep-Oct;28(5):324-7. doi: 10.1177/0148607104028005324.

Abstract

Background: The role of the gut in the development of septic complications and promising clinical results have led to a shift from the parenteral to the enteral route for nutrition support of patients with acute pancreatitis. In patients undergoing surgery for severe necrotizing pancreatitis, the application of a needle catheter jejunostomy might be useful. However, there is a shortage of clinical data on its feasibility and possible harmful effect.

Methods: Between January 1999 and December 2002, 13 patients were operated for severe acute necrotizing pancreatitis. At the time of surgery, needle catheter jejunostomy was performed using a standard technique. Enteral nutrition was initiated without a strict protocol by feeding small amounts of a standard diet and carefully monitoring patient tolerance. As long as necessary, patients were also fed parenterally in order to achieve target caloric goals.

Results: No major tube- or feeding-related complications were observed. A single case of tube dislodgement caused by manipulation during relaparotomy for lavage occurred and was rectified during the same operation.

Conclusions: In patients undergoing surgery for severe acute pancreatitis, needle catheter jejunostomy for long-term enteral nutrition can be applied with no additional risk.

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Catheterization
  • Enteral Nutrition / adverse effects
  • Enteral Nutrition / methods*
  • Female
  • Humans
  • Intubation, Gastrointestinal
  • Jejunostomy / adverse effects
  • Jejunostomy / methods*
  • Male
  • Middle Aged
  • Pancreatitis / surgery
  • Pancreatitis / therapy*
  • Postoperative Complications / epidemiology
  • Risk Factors
  • Treatment Outcome