Charles Y Kim1, Rui Dai2, Qi Wang3, James Ronald2, Sabino Zani4, Tony P Smith2. 1. Division of Interventional Radiology, Duke University Medical Center, Box 3808, Durham, NC, 27710. Electronic address: charles.kim@duke.edu. 2. Division of Interventional Radiology, Duke University Medical Center, Box 3808, Durham, NC, 27710. 3. Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China. 4. Department of Surgery, Duke University Medical Center, Box 3808, Durham, NC, 27710.
Abstract
PURPOSE: To retrospectively compare technical success and major complication rates of laparoscopically versus radiologically inserted jejunostomy tubes. MATERIALS AND METHODS: In this single-institution retrospective study, 115 patients (60 men; mean age, 59.7 y) underwent attempted laparoscopic jejunostomy tube insertion as a standalone procedure during a 10-year period and 106 patients (64 men; mean age, 61.0 y) underwent attempted direct percutaneous radiologic jejunostomy tube insertion during an overlapping 6-year period. Clinical outcomes were retrospectively reviewed with primary focus on predictors of procedure-related major complications within 30 days. RESULTS: Patients undergoing laparoscopic jejunostomy tube insertion were less likely to have previous major abdominal surgery (P < .001) or to be critically ill (P < .001) and had a higher body mass index (P = .001) than patients undergoing radiologic insertion. Technical success rates were 95% (110 of 115) for laparoscopic and 97% (103 of 106) for radiologic jejunostomy tube insertion (P = .72). Major procedural complications occurred in 7 patients (6%) in the laparoscopic group and in 5 (5%) in the radiologic group (P = 1.0). For laparoscopic jejunostomy tubes, only previous major abdominal surgery was significantly associated with a higher major procedure complication rate (14% [5 of 37] vs 3% [2 of 78] in those without; P = .039). In the radiologic jejunostomy group, only obesity was significantly associated with a higher major complication rate: 20% (2 of 10) vs 3% (3 of 96) in nonobese patients (P = .038). CONCLUSIONS: Laparoscopic and radiologic jejunostomy tube insertion both showed high success and low complication rates. Previous major abdominal surgery and obesity may be pertinent discriminators for patient selection.
PURPOSE: To retrospectively compare technical success and major complication rates of laparoscopically versus radiologically inserted jejunostomy tubes. MATERIALS AND METHODS: In this single-institution retrospective study, 115 patients (60 men; mean age, 59.7 y) underwent attempted laparoscopic jejunostomy tube insertion as a standalone procedure during a 10-year period and 106 patients (64 men; mean age, 61.0 y) underwent attempted direct percutaneous radiologic jejunostomy tube insertion during an overlapping 6-year period. Clinical outcomes were retrospectively reviewed with primary focus on predictors of procedure-related major complications within 30 days. RESULTS:Patients undergoing laparoscopic jejunostomy tube insertion were less likely to have previous major abdominal surgery (P < .001) or to be critically ill (P < .001) and had a higher body mass index (P = .001) than patients undergoing radiologic insertion. Technical success rates were 95% (110 of 115) for laparoscopic and 97% (103 of 106) for radiologic jejunostomy tube insertion (P = .72). Major procedural complications occurred in 7 patients (6%) in the laparoscopic group and in 5 (5%) in the radiologic group (P = 1.0). For laparoscopic jejunostomy tubes, only previous major abdominal surgery was significantly associated with a higher major procedure complication rate (14% [5 of 37] vs 3% [2 of 78] in those without; P = .039). In the radiologic jejunostomy group, only obesity was significantly associated with a higher major complication rate: 20% (2 of 10) vs 3% (3 of 96) in nonobese patients (P = .038). CONCLUSIONS: Laparoscopic and radiologic jejunostomy tube insertion both showed high success and low complication rates. Previous major abdominal surgery and obesity may be pertinent discriminators for patient selection.
Authors: H van Overhagen; M A Ludviksson; J S Laméris; A W Zwamborn; H W Tilanus; J Dees; B E Hansen Journal: J Vasc Interv Radiol Date: 2000-01 Impact factor: 3.464
Authors: Charles Y Kim; Bjorn I Engstrom; Jeffrey J Horvath; Matthew P Lungren; Paul V Suhocki; Tony P Smith Journal: J Vasc Interv Radiol Date: 2013-10-01 Impact factor: 3.464
Authors: Maxim Itkin; Mark H DeLegge; John C Fang; Stephen A McClave; Sanjoy Kundu; Bertrand Janne d'Othee; Gloria M Martinez-Salazar; David Sacks; Timothy L Swan; Richard B Towbin; T Gregory Walker; Joan C Wojak; Darryl A Zuckerman; John F Cardella Journal: J Vasc Interv Radiol Date: 2011-07-22 Impact factor: 3.464