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At least 289 records · Page 16Linked to original sources
PubMed1979

A new appliance for collecting ileostomy and jejunostomy fluid in the postoperative period.

A new lightweight two-piece ileostomy appliance was tested in 11 patients with newly established ileostomies and jejunostomies. Seven of the patients presented difficult stoma care problems. The appliance was fitted in theatre on completion of the operation and the patient was followed until discharge from hospital. The appliance remained in place for an average of 4.8 +/- 1.2 days. In a total of 204 patient-days the pouch became dislodged from the flange on 10 occasions and there was leakage under the body flange on 7 occasions. All but one of the patients continued to use the appliance on discharge. No patient was allergic to the appliance nor complained of odour. It is concluded that this new appliance represents an important advance in postoperative stoma care.

Adult↗
PubMed1985

Fine bore jejunostomy feeding following major abdominal surgery: a controlled randomized clinical trial.

A randomized controlled prospective clinical trial has been undertaken to examine the efficacy of the technique of early postoperative feeding using a fine bore catheter jejunostomy. Fifty patients undergoing surgery for gastrointestinal malignancy were randomly allocated into treatment and control groups. A low residue liquidized diet (Isocal) was administered to the patients in the treatment group. Control patients received routine intravenous therapy. Nutritional parameters (serum albumin, serum transferrin, serum prealbumin, weight, body fat and fat free mass) were measured pre-operatively and on the tenth postoperative day. Postoperative surgical complications were similar in both groups. There were 20 catheter complications and one death directly attributable to the jejunal catheter feeding. Postoperative stay was significantly longer (P less than 0.01) in the treatment group patients. Evaluation of the nutritional parameters showed no advantage for either the treatment group or a selected complication-free, 'successful treatment', subgroup. It is concluded that no significant clinical or nutritional advantage for jejunal catheter feeding has been demonstrated and because of the related complications, its routine use cannot be recommended.

Aged↗
PubMed1982

Nonoperative conversion of tube gastrostomy to feeding jejunostomy.

Although esophageal reflux of gastrostomy feeds is an uncommon problem, severe pulmonary complications can arise. If implementation in an upright position and use of continuous infusion does not prevent reflux, an alternative method of providing adequate nutrition must be used. This nonoperative technique of converting a tube gastrostomy to a feeding jejunostomy is simple to perform, atraumatic and extremely useful.

Enteral Nutrition↗
PubMed1984

Nonoperative replacement of a jejunostomy feeding catheter.

Nonoperative replacement of lost or occluded jejunal feeding catheters proved successful in 8 of 11 patients. This technique is recommended as a nonoperative means of replacing a needle catheter jejunostomy when it is accidentally lost or becomes occluded. Adherence to sterile technique and gentle advancement of the guide wire to avoid injury to the bowel are important. Since the technique depends on an established tract between the skin and the bowel, catheter replacement should not be attempted when the feeding catheter is lost or becomes occluded in the immediate postoperative period. In addition, confirmation of catheter patency and intraluminal position with sterile water-soluble contrast medium is critical to the safe use of this technique.

Catheterization↗
PubMed1985

Early postoperative nutritional enhancement utilizing enteral branched-chain amino acids by way of a needle catheter jejunostomy.

Twenty patients who underwent extensive intraabdominal surgical procedures and placement of a needle catheter jejunostomy were prospectively studied to evaluate gastrointestinal tolerance and nutritional enhancement when fed an enteral branched-chain amino acid-enriched diet. At a mean caloric intake of 1,325.75 kcal/day (20.6 kcal/kg per day) and a mean nitrogen intake of 7.64 g/day (0.12 g/kg per day), positive nitrogen balance was achieved 2 to 3 days postoperatively. Total lymphocyte count and levels of transferrin and prealbumin increased significantly (p less than 0.05) during the study. Gastrointestinal tolerance was excellent. Plasma levels of leucine, isoleucine, and valine increased significantly during the study period but remained within the normal range.

Abdomen↗
PubMed1986

A method for stabilizing chronic gastrostomy or jejunostomy tubes.

Haphazard and inefficient securing of chronic gastrostomy or jejunostomy tubes causes major complications due to migration of the percutaneous feeding tube, including pyloric or intestinal obstruction, obstructive jaundice, and impaired feeding. These problems associated with current anchoring techniques can be prevented by following an inexpensive, easily learned stabilization method using sterile gauze pads and tape that fixes the tube in position.

Bandages↗
PubMed1986

Patients with a high jejunostomy do not need a special diet.

Absorption from a chemically defined liquid feed consisting of small peptides, oligosaccharides, and little fat (half medium-chain triglycerides) was compared with that from a feed of whole protein, polysaccharides, and long-chain triglycerides in 7 patients with less than 150 cm of jejunum ending in a stoma. Comparisons of absorption from three solid food diets varying in their fiber and fat content but containing equal amounts of nitrogen and minerals were also made in 4 of the patients. There were no consistent differences between the two liquid or three solid-food diets in percentage of calorie, nitrogen, or fat absorption. The absolute loss of fat depended on the fat intake, but larger losses did not appear detrimental. A liquid diet consisting of peptides, oligosaccharides, and medium-chain triglycerides is not more beneficial than a polymeric diet in patients with a high jejunostomy. A liberal attitude is appropriate toward the fat and fiber content of the diet. Electrolyte supplements, especially sodium and magnesium, are often needed.

Adult↗
PubMed1994

Pancreatic pleural effusion: an indication for emergency distal pancreatectomy and Roux-en-Y pancreatico-jejunostomy.

A previously healthy 2-year-old boy was admitted because of shortness of breath, cough, and fever; there was minimal abdominal pain. He had recurrent right, followed by left pleural effusions, which contained markedly elevated amylase levels and high protein content. The pleural fluid amylase levels were disproportionately higher than the serum amylase levels. His abdominal signs were minimal. Surgical exploration showed a disruption of the proximal pancreatic duct. Distal pancreatectomy and Roux-en-Y pancreatico-jejunostomy were performed. After a complicated postoperative course he was discharged well and has remained so for more than 2 years.

Anastomosis, Roux-en-Y↗
PubMed1992

A patient with jejunostomy liberated from home intravenous therapy after 14 years; contribution of balance studies.

A patient with a jejunostomy 100 cm from the duodeno-jejunal flexure, following surgery for Crohn's disease, had needed parenteral fluids at home for 14 years because of a negative intestinal balance of sodium. Measurements were made of her oral intake and intestinal output during study periods each of 2 days. Loperamide 4 mg QDS, codeine phosphate 60 mg QDS and both together put her into positive intestinal fluid balance but sodium balance remained negative. Both drugs used together were more effective than either used alone. Ranitidine 300 mg BD made no significant difference to her intestinal output. 1 litre of a glucose-electrolyte solution (120 mmol sodium) sipped during the day resulted in sodium balance, but only with the addition of loperamide and codeine phosphate was positive sodium balance achieved (mean 44 mmol/day). This therapy allowed her to dispense with parenteral fluids which have been stopped for the last year.

Journal Article↗
PubMed2004

Effect of surgery for chronic pancreatitis on pancreatic function: pancreatico-jejunostomy and duodenum-preserving resection of the head of the pancreas.

BACKGROUND: Resection and drainage procedures are performed for chronic pancreatitis. After resection, pancreatic function deteriorates; however, little is known about the effect of drainage procedures. METHODS: Pancreatic function was evaluated prospectively before and after surgery in 27 patients with duodenum-preserving resection of the head of the pancreas (DPRHP), and in 12 patients with pancreatico-jejunostomy (P-JS); 18 patients with chronic pancreatitis served as controls. Results of the 2 groups were not compared because of differences in patient characteristics and indications for surgery. Endpoints were exocrine function (fecal fat excretion, urinary PABA recovery), endocrine function (oral glucose tolerance test, serum C-peptide concentrations), and pancreatic polypeptide secretion. RESULTS: Groups were not different with respect to age and duration of symptoms. Median urinary PABA recovery was not altered significantly after surgery: DPRHP, from 40% to 31%; P-JS, from 52% to 44%; and controls, from 43% to 48%. Median fecal fat also did not change significantly: DPRHP, from 6 to 12 g/24 h; P-JS, from 9 to 5 g/24 h; and controls, from 6 to 7 g/24 h. Although the integrated blood glucose value did not change after DPRHP, the integrated serum C-peptide value decreased after DPRHP (P<.02). After P-JS, the integrated blood glucose value decreased (P<.02), but there was no change in integrated serum C-peptide secretion. Neither integrated blood glucose nor C peptide values were affected in controls. Insulin dependency increased (22% to 33%) after DPRHP. Pancreatic polypeptide secretion decreased only after DPRHP (P=.003). CONCLUSIONS: Surgery for chronic pancreatitis does not influence exocrine pancreatic function after either a drainage (P-JS) or a resection procedure (DPRHP). Clinical endocrine function is not affected after DPRHP but improves after P-JS.

Blood Glucose↗
PubMed1982

Use of high jejunostomy in extensive NEC.

Use of a stoma above involved bowel has been suggested as an option in the infant found to have NEC of an extent which precludes resection. This achieves total decompression and places the involved bowel at rest. A 1-mo-old infant developed NEC after a week of diarrhea. Pneumoperitoneum prompted exploration and involvement of the entire small bowel with a perforation of the ileum was present. The perforation was sutured and a jejunostomy performed within 6 in of the duodenum. Recovery was smooth. After 3 wk of central IV alimentation weight gain was steady and a contrast study ruled out stenosis of the colon. The stoma was resected and bowel continuity restored. Subsequent growth and development have been normal. This approach offers promise in extensive NEC and should be considered early in a patient who fails to improve promptly with intensive medical management.

Enterocolitis, Pseudomembranous↗
PubMed1984

Early postoperative enteral feeding through a needle catheter jejunostomy.

The advantages of early postoperative enteral nutrition through a needle catheter jejunostomy in 13 operated children (1 day to 14 years) are analysed. They presented various surgical or medical diseases. 8 of them had a duodenal atresia or stenosis. Their postoperative follow-up was compared with other children suffering from the same pathology without early postoperative enteral feeding. The simplicity of the realimentation, the absence of septic complications and the metabolic advantages of this method prove to be extremely efficient when a protein and calorie malnutrition must be avoided and fractionated oral feeding is impossible.

Adolescent↗
PubMed1986

Benefits of immediate jejunostomy feeding after major abdominal trauma--a prospective, randomized study.

Benefits of immediate postinjury nutritional support remain ill defined. Seventy-five consecutive patients undergoing emergent celiotomy with an abdominal trauma index (A.T.I.) greater than 15 were randomized prospectively to a control group (no supplemental nutrition during first 5 days) or enteral-fed group. The enteral patients had a needle catheter jejunostomy (N.C.J.) placed at laparotomy with the constant infusion of an elemental diet (Vivonex HN) begun at 18 hours and advanced to 3,000 ml/day (3,000 kcal, 20 gm N2) within 72 hours. Control and enteral-fed groups were comparable with respect to demographic features, trauma mechanism, shock, colon injury, splenectomy, A.T.I., and initial nutritional assessment. Twenty (63%) of the enteral patients were maintained on the elemental diet greater than 5 days; four (12%) needed total parenteral nutrition (T.P.N.). Nine (29%) of the control patients required T.P.N. Nitrogen balance was markedly improved (p less than 0.001) in the enteral-fed group. Although visceral protein markers and overall complication rate were not significantly different, septic morbidity was greater (p less than 0.025) in the control group (abdominal infection in seven and pneumonia in two) compared to the enteral-fed patients (abdominal abscess in three). Analysis of patients with A.T.I. 15-40 disclosed sepsis in seven (26%) of the control versus one (4%) of the enteral-fed group (p less than 0.01). Our clinical experience demonstrates the feasibility of immediate postoperative enteral feeding via N.C.J. after major abdominal trauma, and suggests this early nutrition reduces septic complications in critically injured patients.

Abdominal Injuries↗
PubMed1980

Aspirin absorption from a feeding jejunostomy.

In a 67-year-old man who had a feeding jejunostomy because of dysphagia paralytica, the absorption of aspirin was measured in terms of serum salicylate concentration. A 975-mg dose of aspirin was given as a slurry in water directly into the feeding tube. Peak serum levels of salicylate were well correlated with those in previous studies of aspirin absorption by the oral route in a geriatric population. However, unexpectedly, the half-life of the drug in this patient was twice as long (7.5 hours) as that found in six previous studies (3.7 hours) of elderly patients given similar doses.

Aged↗
PubMed1973

New jejunostomy feed.

Three patients with duodenal fistulae were fed solely with an easily prepared, inexpensive jejunostomy feed for 14, 21, and 23 days respectively. Sodium, potassium, and nitrogen balances became positive, diarrhoea did not develop, and body weight increased. The feed was life-saving: the patients' superficial veins were thrombosed, and percaval feeding was considered undesirable.

Animals↗
PubMed2003

Ins and outs of enteral access. Part 3: long-term access--jejunostomy.

Feeding jejunostomy tubes can be useful in patients with gastroesophageal reflux or a nonfunctioning stomach and can be short-term, long-term, or permanent. These tubes can be inserted surgically, endoscopically, radiologically, or laparoscopically. Each of these techniques is described, and their mortality, morbidity, advantages, and disadvantages are compared.

Journal Article↗