Efficient Decompression and Immediate Enteral Hyperalimentation via Gastrostomy as an Adjunct to Gastroplasty

Abstract

A triple-lumen Moss(c) gastrostomy tube was advanced into the proximal duodenum as an adjunct to the postoperative management of patients who underwent vertical banded gastroplasty (VBG) for the treatment of morbid obesity. The tube efficiently aspirated the proximal duodenum and stomach to prevent postoperative ileus and allow maximum immediate postoperative absorption of an elemental diet fed simultaneously into the distal duodenum. Decompression and feeding were started as soon as the patient arrived in the recovery room. Both were continued for at least the first 48 h after surgery. Patients seemed to improve better clinically on this postoperative regimen than with only the traditional i.v. infusion of fluids, carbohydrates, and electrolytes. The length of stay also was shorter than that allowed in the Diagnosis Related Group (DRG) for the; surgical management of morbid obesity: with the average of 3.0 days (range 2-6 days) versus the general mean length of stay of 7.4 days. Immediate enteral decompression and hyperalimentation through a gastroduodenostomy tube is a useful adjunct to the post-VBG treatment of morbidly obese patients.