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

JPEN J Parenter Enteral Nutr

Klinik für Allgemeinn und Visceralchirurgie, Städtisches Klinikum St. Georg, Leipzig, Germany.

Published: April 2005

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.

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http://dx.doi.org/10.1177/0148607104028005324DOI Listing

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