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Semin intervent Radiol 2025; 42(01): 043-047
DOI: 10.1055/s-0044-1801745
Review Article

Percutaneous Jejunostomy

Adam P. Jacobs
1   Division of Vascular and Interventional Radiology, University of Alabama at Birmingham, Birmingham, Alabama
,
Nancy Ann B. Little
1   Division of Vascular and Interventional Radiology, University of Alabama at Birmingham, Birmingham, Alabama
,
Junaid Raja
1   Division of Vascular and Interventional Radiology, University of Alabama at Birmingham, Birmingham, Alabama
,
Stephen R. Brown
1   Division of Vascular and Interventional Radiology, University of Alabama at Birmingham, Birmingham, Alabama
,
Andrew J. Gunn
1   Division of Vascular and Interventional Radiology, University of Alabama at Birmingham, Birmingham, Alabama
,
Junjian Huang
1   Division of Vascular and Interventional Radiology, University of Alabama at Birmingham, Birmingham, Alabama
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Abstract

Direct percutaneous jejunostomy placement is an often underutilized procedure that can allow for supplemental enteral nutrition in a certain subset of patients, in which percutaneous gastrostomy is not technically feasible, or in patients who require post-pyloric feeding. Percutaneous jejunostomy catheter placement was first described in the 1980s; since that time there have been minimal case series on the procedural technique and outcomes. At our institution, we perform percutaneous jejunostomy placement as a planned two-stage procedure. During the initial stage, direct jejunostomy is performed under a combination of fluoroscopic and ultrasound guidance, after distending the jejunum through a nasojejunal tube. After confirming intraluminal access, at least one Cope suture anchor is deployed, and guidewire access is maintained. Subsequently, the track is serially dilated, and a 14-Fr pigtail catheter is placed into the jejunum. Approximately 4 to 6 weeks later, the patient returns for conversion of the pigtail drain into a formal jejunostomy catheter with retention balloon, under fluoroscopic guidance. Several of the prior larger studies on the technique have noted major complications to occur in 12% of patients and minor complications to occur in 9.8% of patients. While percutaneous jejunostomy placement is not a frequently performed procedure, technical success and complication rates are comparable to that of surgical jejunostomy.

Keywords

percutaneous jejunostomy - interventional radiology - feeding tube - enteral feeding


Publication History

Article published online:
24 January 2025

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  • References

  • 1 Huang Y, Wang Y, Chase RC. et al. Increased inpatient gastrostomy and jejunostomy tube placement during the 2020 COVID-19 pandemic. iGIE 2023; 2 (03) 312-318
    CrossrefPubMedSearch in Google Scholar
  • 2 Gray RR, Ho CS, Yee A, Montanera W, Jones DP. Direct percutaneous jejunostomy. AJR Am J Roentgenol 1987; 149 (05) 931-932
    CrossrefPubMedSearch in Google Scholar
  • 3 Patel IJ, Rahim S, Davidson JC. et al. Society of Interventional Radiology Consensus Guidelines for the periprocedural management of thrombotic and bleeding risk in patients undergoing percutaneous image-guided interventions - Part II: Recommendations: endorsed by the Canadian Association for Interventional Radiology and the Cardiovascular and Interventional Radiological Society of Europe. J Vasc Interv Radiol 2019; 30 (08) 1168-1184.e1
    CrossrefPubMedSearch in Google Scholar
  • 4 Itkin M, DeLegge MH, Fang JC. et al; Society of Interventional Radiology, American Gastroenterological Association Institute, Canadian Interventional Radiological Association, Cardiovascular and Interventional Radiological Society of Europe. Multidisciplinary practical guidelines for gastrointestinal access for enteral nutrition and decompression from the Society of Interventional Radiology and American Gastroenterological Association (AGA) Institute, with endorsement by Canadian Interventional Radiological Association (CIRA) and Cardiovascular and Interventional Radiological Society of Europe (CIRSE). Gastroenterology 2011; 141 (02) 742-765
    CrossrefPubMedSearch in Google Scholar
  • 5 Boullata JI, Carrera AL, Harvey L. et al; ASPEN Safe Practices for Enteral Nutrition Therapy Task Force, American Society for Parenteral and Enteral Nutrition. ASPEN safe practices for enteral nutrition therapy [formula: see text]. JPEN J Parenter Enteral Nutr 2017; 41 (01) 15-103
    CrossrefPubMedSearch in Google Scholar
  • 6 Ajani JA, Bentrem DJ, Besh S. et al; National Comprehensive Cancer Network. Gastric cancer, version 2.2013: featured updates to the NCCN Guidelines. J Natl Compr Canc Netw 2013; 11 (05) 531-546
    CrossrefPubMedSearch in Google Scholar
  • 7 van Overhagen H, Ludviksson MA, Laméris JS. et al. US and fluoroscopic-guided percutaneous jejunostomy: experience in 49 patients. J Vasc Interv Radiol 2000; 11 (01) 101-106
    CrossrefPubMedSearch in Google Scholar
  • 8 Hu HT, Shin JH, Song HY. et al. Fluoroscopically guided percutaneous jejunostomy with use of a 21-gauge needle: a prospective study in 51 patients. J Vasc Interv Radiol 2009; 20 (12) 1583-1587
    CrossrefPubMedSearch in Google Scholar
  • 9 Yang ZQ, Shin JH, Song HY. et al. Fluoroscopically guided percutaneous jejunostomy: outcomes in 25 consecutive patients. Clin Radiol 2007; 62 (11) 1061-1065 , discussion 1066–1068
    CrossrefPubMedSearch in Google Scholar
  • 10 Kim CY, Dai R, Wang Q, Ronald J, Zani S, Smith TP. Jejunostomy tube insertion for enteral nutrition: comparison of outcomes after laparoscopic versus radiologic insertion. J Vasc Interv Radiol 2020; 31 (07) 1132-1138
    CrossrefPubMedSearch in Google Scholar
  • 11 Richard HM, Widlus DM, Malloy PC. Percutaneous fluoroscopically guided jejunostomy placement. J Trauma 2008; 65 (05) 1072-1077
    PubMedSearch in Google Scholar
  • 12 Kim CY, Engstrom BI, Horvath JJ, Lungren MP, Suhocki PV, Smith TP. Comparison of primary jejunostomy tubes versus gastrojejunostomy tubes for percutaneous enteral nutrition. J Vasc Interv Radiol 2013; 24 (12) 1845-1852
    CrossrefPubMedSearch in Google Scholar