Feasibility And Safeness Of Ultrasound-Guided Percutaneous Jejunostomy.

Purpose: To determine the feasibility and safeness of ultrasound-guided percutaneous jejunostomy for feeding purposes.Materials and methods: Percutaneous jejunostomy was attempted 37 times in 34 patients.Indication was obstruction of esophagus/stomach n=29, postoperative malnutrition n=6, postoperative leakage n=l and neurologic disorder n=l.The jejunum was punctured under ultrasound guidance.The needle position was controlled fluoroscopically by injecting contrast material.A guide wire was introduced and a 10F self retaining pigtail catheter was inserted.A Cope anchor was used in 21, a naso-enteric tube in 16 and Glucagon i.v. in 15 cases.Results: The technical succes rate was 81% (30 of 37 procedures).Seven (19%) attempts failed because the jejunum could not be punctured (n=6) or the guidewire dislodged when inserting the catheter (n=l).There were seven (19%) complications; severe pain managed conservatively (n=4), pericatheter leakage (n=l), catheter malposition (n=l), pericatheter abscess n=l.There were three (9%) nonprocedure-related deaths within 30 days.Twenty-four catheters have been removed (elective n=l 1, death n=9, leakage n=l, dislodgement n=l, other n=2) after 1-268 (mean 61) days.Six catheters are in situ for 39-431 (mean 198) days and are functioning adequately.Conclusion: Ultrasound-guided percutaneous jejunostomy is a safe and feasible procedure with acceptable complication rates.