Feeding jejunostomy during Whipple is associated with increased morbidity

James C. Padussis, Sabino Zani, Dan G. Blazer, Douglas Tyler, Theodore N. Pappas, John E. Scarborough

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background: Placement of a feeding jejunostomy tube (FJ) is often performed during pancreaticoduodenectomy (PD). Few studies, however, have sought to determine whether such placement affects postoperative outcomes after PD. Materials and methods: This is a retrospective analysis of the National Surgical Quality Improvement Program (NSQIP) database to determine the 30-d-postoperative mortality rate, major complication rate, and overall complication rate of jejunostomy tube placement at the time of PD. Univariate and multivariate comparison of postoperative outcomes between patients with and without FJ placement during PD was performed on a total of 4930 patients. Results: Thirty-day-postoperative mortality did not differ between the two groups (4.0% for patients with FJ versus 2.7% without, P = 0.13), whereas overall morbidity (43.3% with FJ versus 34.6% without, P < 0.0001) and serious morbidity (29.5% with FJ versus 22.8% without, P < 0.0001) were significantly higher in patients undergoing FJ placement during PD. The specific complications that occurred more frequently in FJ patients than patients without FJ included deep space surgical site infection, pneumonia, unplanned reintubation, acute renal failure, and sepsis. Conclusion: Although FJ placement during PD is considered to be routine at many institutions, our analysis of data from NSQIP suggest that FJ placement may be associated with increased postoperative morbidity.

Original languageEnglish (US)
Pages (from-to)361-366
Number of pages6
JournalJournal of Surgical Research
Volume187
Issue number2
DOIs
StatePublished - Apr 2014
Externally publishedYes

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Jejunostomy
Enteral Nutrition
Morbidity
Pancreaticoduodenectomy
Quality Improvement
Surgical Wound Infection
Mortality
Acute Kidney Injury
Sepsis
Pneumonia

Keywords

  • Feeding jejunostomy
  • NSQIP
  • Pancreaticoduodenectomy

ASJC Scopus subject areas

  • Surgery

Cite this

Padussis, J. C., Zani, S., Blazer, D. G., Tyler, D., Pappas, T. N., & Scarborough, J. E. (2014). Feeding jejunostomy during Whipple is associated with increased morbidity. Journal of Surgical Research, 187(2), 361-366. https://doi.org/10.1016/j.jss.2012.10.010

Feeding jejunostomy during Whipple is associated with increased morbidity. / Padussis, James C.; Zani, Sabino; Blazer, Dan G.; Tyler, Douglas; Pappas, Theodore N.; Scarborough, John E.

In: Journal of Surgical Research, Vol. 187, No. 2, 04.2014, p. 361-366.

Research output: Contribution to journalArticle

Padussis, JC, Zani, S, Blazer, DG, Tyler, D, Pappas, TN & Scarborough, JE 2014, 'Feeding jejunostomy during Whipple is associated with increased morbidity', Journal of Surgical Research, vol. 187, no. 2, pp. 361-366. https://doi.org/10.1016/j.jss.2012.10.010
Padussis, James C. ; Zani, Sabino ; Blazer, Dan G. ; Tyler, Douglas ; Pappas, Theodore N. ; Scarborough, John E. / Feeding jejunostomy during Whipple is associated with increased morbidity. In: Journal of Surgical Research. 2014 ; Vol. 187, No. 2. pp. 361-366.
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