May be indicated when more than one week of fasting has occurred or is anticipated & is usually performed as part of another intra-abdominal operation.
- Identify the proximal jejunum.
- Choose the first or second loop as the loop to be brought up for the jejunostomy.
- A stab incision into the jejunum allows insertion & distal threading of a commercially available jejunostomy tube. This is held in situ with a series of purse-string sutures.
- The tube is brought through the abdominal wall via a separate stab.
- The jejunum is anchored to the inside of the peritoneal wall with absorbable sutures.
- The jejunostomy tube is sutured to the abdominal skin to prevent dislocation.
Commence jejunal feeding at slow rate immediately postoperatively.
Main Postoperative Complications
- Delayed jejunal peristalsis with prolonged nasogastric aspirate.
- Jejunostomy leak