Feeding jejunostomy after pancreaticoduodenectomy: Benefit or burden?
| Title: | Feeding jejunostomy after pancreaticoduodenectomy: Benefit or burden? |
|---|---|
| Authors: | Jebakumar GS; Department of Surgical Gastroenterology, Apollo Hospitals, Chennai, India.; Tasgaonkar S; Department of Surgical Gastroenterology, Apollo Hospitals, Chennai, India.; Muthiah J; Department of Surgical Gastroenterology, Apollo Hospitals, Chennai, India.; Chinappa G; Department of Surgical Gastroenterology, Apollo Hospitals, Chennai, India.; Anand K S S; Department of Surgical Gastroenterology, Apollo Hospitals, Chennai, India.; Jameel JKA; Department of Surgical Gastroenterology, Apollo Hospitals, Chennai, India.; Balachandar TG; Department of Surgical Gastroenterology, Apollo Hospitals, Chennai, India.; Swain SK; Department of Surgical Gastroenterology, Apollo Hospitals, Chennai, India. |
| Source: | Annals of hepato-biliary-pancreatic surgery [Ann Hepatobiliary Pancreat Surg] 2025 Aug 31; Vol. 29 (3), pp. 317-322. Date of Electronic Publication: 2025 Jun 18. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Korean Association of Hepato-Biliary-Pancreatic Surgery Country of Publication: Korea (South) NLM ID: 101698342 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2508-5859 (Electronic) Linking ISSN: 25085859 NLM ISO Abbreviation: Ann Hepatobiliary Pancreat Surg Subsets: PubMed not MEDLINE |
| Imprint Name(s): | Original Publication: [Seoul, Korea] : Korean Association of Hepato-Biliary-Pancreatic Surgery, [2016]- |
| Abstract: | Backgrounds/aims: Pancreaticoduodenectomy (PD) is the standard treatment for resectable tumors of the pancreatic head, ampulla, distal bile duct, and duodenum. Despite advances, delayed gastric emptying (DGE) remains a common complication. Feeding jejunostomy (FJ) is often used during PD, though its necessity and association with increased morbidity, particularly DGE, remain controversial. This study aimed to evaluate early postoperative outcomes in PD patients with or without FJ, focusing on DGE and related complications.; Methods: This prospective observational study was conducted from August 2022 to April 2024 and included 56 patients (28 with FJ, 28 without). Primary outcomes were DGE, postoperative pancreatic fistula (POPF), and hospital stay. Secondary outcomes included FJ-related complications, surgical site infections, and time to tolerate solid food. Statistical analysis was performed using SPSS v28.; Results: DGE was significantly more frequent in the FJ group (78.6% vs. 39.3%, p = 0.006). Clinically relevant DGE (grades B/C) was also higher with FJ (60.7% vs. 21.4%, p = 0.008). FJ-related complications, including intestinal obstruction requiring reoperation, occurred in 10.7% of patients. Time to tolerate solid food and hospital stay were longer in the FJ group. Multivariate analysis identified FJ use and perioperative blood transfusion as independent risk factors for DGE.; Conclusions: Routine FJ placement in PD is associated with increased DGE and tube-related complications. A selective approach to FJ may improve postoperative outcomes. Larger multicenter randomized trials are needed to validate these findings and develop clear guidelines for FJ use in PD. |
| References: | Cureus. 2023 Jul 13;15(7):e41828. (PMID: 37575744); Am J Surg. 2017 Mar;213(3):530-533. (PMID: 27863719); Ann Surg. 1992 Aug;216(2):172-83. (PMID: 1386982); HPB (Oxford). 2020 Jan;22(1):20-25. (PMID: 31353255); Br J Anaesth. 2023 Dec;131(6):1002-1013. (PMID: 37741720); Chin Clin Oncol. 2017 Dec;6(6):64. (PMID: 29156887); JPEN J Parenter Enteral Nutr. 2014 Nov;38(8):996-1002. (PMID: 23963691); Medeni Med J. 2020;35(3):181-187. (PMID: 33110669); HPB (Oxford). 2022 Oct;24(10):1615-1621. (PMID: 35606323); Maedica (Bucur). 2022 Dec;17(4):840-845. (PMID: 36818256); Pancreatology. 2013 Jan-Feb;13(1):63-71. (PMID: 23395572); Ann Surg Open. 2024 Jun 28;5(3):e458. (PMID: 39310336); J Gastrointest Surg. 2020 Apr;24(4):959-963. (PMID: 31993965); J Gastrointest Surg. 2012 Jun;16(6):1144-51. (PMID: 22528573); J Surg Res. 2014 Apr;187(2):361-6. (PMID: 24525057); Br J Surg. 2013 Apr;100(5):589-98; discussion 599. (PMID: 23354970); Am J Surg. 2019 Mar;217(3):458-462. (PMID: 30538033); HPB (Oxford). 2022 Jan;24(1):30-39. (PMID: 34274231); J Gastrointest Surg. 2004 Sep-Oct;8(6):733-41. (PMID: 15358336); eGastroenterology. 2023 Sep;1(2):. (PMID: 38292831) |
| Contributed Indexing: | Keywords: Delayed gastric emptying; Feeding jejunostomy; Pancreaticoduodenectomy; Whipple procedure |
| Entry Date(s): | Date Created: 20250617 Date Completed: 20250913 Latest Revision: 20250913 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC12377983 |
| DOI: | 10.14701/ahbps.25-035 |
| PMID: | 40527757 |
| Database: | MEDLINE |
Journal Article