Fluoroscopically Guided Percutaneous Jejunostomy with Use of a 21-gauge Needle: A Prospective Study in 51 Patients

Abstract

To assess the safety and clinical efficacy of fluoroscopically guided percutaneous jejunostomy with use of a 21-gauge needle and a single anchor technique in 51 patients. From November 2006 to January 2009, 51 consecutive patients (42 men and nine women; mean age, 63.7 years) underwent percutaneous jejunostomy under fluoroscopic guidance. A 7.5-F multifunctional coil catheter was used to insufflate the jejunum. The distended jejunum was punctured with a 21-gauge needle, with the inserted coil catheter as the target. A single anchor was used. The technical success, number of punctures, procedure time, complications, and follow-up data including 30-day mortality rate were evaluated. The technical success rate was 100%, and the single anchor technique was used in all but one patient, in whom three anchors were used. The mean number of punctures was 1.7 (range, 1-4), and the mean procedure time was 14.8 minutes (range, 7-29 min). Peritonitis was a major complication in two patients (3.9%), who were treated by changing the catheters from 14 F to 16 F and performing percutaneous drainage procedures. Three minor complications were encountered: superficial cellulitis (n = 2) and severe puncture site pain (n = 1). The 30-day mortality rate was 5.9% (three of 51), although none of the deaths could be attributed to the jejunostomy procedures. Fluoroscopically guided percutaneous jejunostomy with use of a 21-gauge needle and the single anchor technique seems to be safe and effective, with high technical success and low complication rates.