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.

Procedure

• 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.

Postoperative Management

Commence jejunal feeding at slow rate immediately postoperatively.

Main Postoperative Complications

• Delayed jejunal peristalsis with prolonged nasogastric aspirate.
• Jejunostomy leak