Laparoscopic gastrostomy and jejunostomy are safe and effective for obtaining enteral access

American Journal of Surgery
K M MurayamaJ S Thompson

Abstract

Laparoscopic gastrostomy (lap g-tube) and jejunostomy (lap j-tube) are relatively new procedures that do not require laparotomy. Our aim was to determine the role of laparoscopic feeding tube placement for enteral access and the safety of these techniques. We reviewed our experience with attempted laparoscopic placement of 93 enteral tubes in 81 patients over a 3-year period. Patients received either a lap g-tube (n = 64), lap j-tube (n = 5), or both lap g/j-tube (n = 12). When enteral access was needed for nutritional support, the choice of lap g-tube or lap j-tube was based on risk of gastroesophageal reflux. The most common underlying conditions requiring tube placement were head and neck cancer (49%), neurologic disorders (19%), and trauma (11%). Mean operative times (minutes) were as follows (mean +/- SD): lap g-tube (39 +/- 7), lap j-tube (63 +/- 10), and lap g/j-tube (85 +/- 13). Lap g-tube placement was successful in 73 (96%) of 76 patients and lap j-tube in all 17 patients. The major complication rate for all tubes was 8% (7 of 93) and included gastrointestinal bleeding, wound infection, and failed placement. Five patients died in the 30-day period following surgery, but none of the deaths was procedure related. Laparo...Continue Reading

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