Jejunostomy

Jejunostomy is a surgical procedure that involves the placement of a feeding tube directly into the jejunum, which is a section of the small intestine. Jejunostomy may be recommended for patients who are unable to eat or digest food through the normal digestive system due to conditions such as esophageal cancer, severe gastrointestinal obstruction, or other conditions that limit the function of the stomach and/or small intestine. There are several types of jejunostomy procedures, each with its own unique benefits and considerations.

Types of Jejunostomy Procedures:

1. Percutaneous Endoscopic Jejunostomy (PEJ): PEJ is a minimally invasive procedure in which an endoscope is used to guide the placement of a feeding tube through the abdominal wall and into the jejunum. This procedure is typically performed under sedation or general anesthesia. The benefits of PEJ include a shorter recovery time, less pain, and a lower risk of complications compared to traditional surgery.
2. Open Jejunostomy: Open jejunostomy is a traditional surgical procedure in which an incision is made in the abdomen to directly access the jejunum. The feeding tube is then inserted through the opening and secured in place. This procedure requires general anesthesia and a longer recovery time. However, it may be necessary in cases where the patient has a complex medical history or when other procedures have failed.
3. Laparoscopic Jejunostomy: Laparoscopic jejunostomy is a minimally invasive procedure that involves making several small incisions in the abdomen and inserting a laparoscope, which is a small camera, to guide the placement of the feeding tube. This procedure has several advantages, including a shorter hospital stay, faster recovery time, and less scarring.

Procedure Details:

Before the Procedure: Before the jejunostomy procedure, the patient will undergo a thorough physical examination and medical history review. They will also receive instructions on how to prepare for the procedure, which may include fasting and stopping certain medications. In some cases, a bowel prep may be required to clean out the intestines.

During the Procedure: The procedure will be performed under sedation or general anesthesia. The surgeon will make an incision in the abdomen and create an opening in the jejunum. The feeding tube will be inserted through the opening and secured in place with stitches or an external device. The procedure typically takes one to two hours to complete.

After the Procedure: After the jejunostomy procedure, the patient will be monitored in a recovery room for several hours. They will be given pain medication and antibiotics to prevent infection. The feeding tube will be checked for proper placement and function, and the patient will receive instructions on how to care for the tube at home. The patient may need to stay in the hospital for several days to recover and receive additional nutrition.

Conclusion:

Jejunostomy is a valuable surgical option for patients who require nutrition support but are unable to consume food through the normal digestive system. There are several types of jejunostomy procedures available, each with its own benefits and considerations. Patients should work closely with their healthcare team to determine the most appropriate type of jejunostomy procedure for their individual needs, and to receive guidance on how to care for the feeding tube after the procedure.