Feasibility and safety of needle catheter jejunostomy for enteral nutrition in surgically treated severe acute pancreatitis

BACKGROUND: The role of the gut in the development of septic complications and promising clinical results have led to a shift from the parenteral to the enteral route for nutrition support of patients with acute pancreatitis. In patients undergoing surgery for severe necrotizing pancreatitis, the application of a needle catheter jejunostomy might be useful. However, there is a shortage of clinical data on its feasibility and possible harmful effect. METHODS: Between January 1999 and December 2002, 13 patients were operated for severe acute necrotizing pancreatitis. At the time of surgery, needle catheter jejunostomy was performed using a standard technique. Enteral nutrition was initiated without a strict protocol by feeding small amounts of a standard diet and carefully monitoring patient tolerance. As long as necessary, patients were also fed parenterally in order to achieve target caloric goals. RESULTS: No major tube- or feeding-related complications were observed. A single case of tube dislodgement caused by manipulation during relaparotomy for lavage occurred and was rectified during the same operation. CONCLUSIONS: In patients undergoing surgery for severe acute pancreatitis, needle catheter jejunostomy for long-term enteral nutrition can be applied with no additional risk.