Study on Endoscopic Insertion of the Enteral Feeding Tube for Patients with Anastomotic Impassability After Gastrectomy

Abstract

We have investigated about the enteral feeding tube for anastomotic impassability caused by anastomotic inflammation, ulcer, failure after gastrectomy. Subjects: 67 patients who needed enteral feeding because of anastomotic impassability among 1865 patients after gastrectomy from gastric and duodenal ulcer, gastric carcinoma at Pyongyang Medical College Hospital of Kim Il Sung University and other hospitals from February 2007 to August 2015. Method: The aim is to place the enteral feeding tube into the jejunum. At first we inserted the upper gastrointestinal endoscope into the jejunum beyond the anastomotic site and pulled out the it after inserting the guide wire into jejunum through the endoscope. Then we inserted the enteral feeding tube into the jejunum following the guidewire and pulled out it either. Finally we confirmed it by radiography. Results: 71 insertions were applied for 67 patients, among them the number of successes was 67 (94.4%), and required time was 14.4±3.8min, the length of the guidewire inserted into the jejunum was 23.1±2.8cm. The gastric juice output of the patients with anastomotic inflammation and ulcer was 1218±181mL/d before insertion of the tube, but 0 mL/d after insertion. And it was 1218±181mL/d before insertion in anastomotic failure, and it decreased by 5.8±3.0mL/d on the 7 th day after insertion. 2 patients (3.0%) underwent reoperation. Conclusion: This procedure is very high successful and takes a short time, can prevent the pooling of intragastric juice and reoperation.