Jejunostomy

Barber, W. Howard

doi:10.1097/00000658-193304000-00009

Cited by 5 publications

(4 citation statements)

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“…Despite the availability of these jejunostomy techniques, numerous complications and the lack of a definite benefit of jejunal feeding limited the popularity of feeding jejunostomy. Barber&dquo; reported the preceding 13 years' experience with feeding jejunostomy at the Bellevue Hospital. Only 20 Witzel jejunostomies had been performed.…”

Section: Lb Over 5 Monthsmentioning

confidence: 99%

“…In the mobile portion of the jejunum just distal to the ligament of Treitz or to a gastrojejunal anastomosis, one creates a seromuscular tunnel by inserting a 14-gauge needle within the wall of the bowel through a 3-0 silk purse string suture. The needle is then turned into the lumen of the bowel and [12][13][14][15][16][17][18] inches of a 16-gauge catheter are threaded down the lumen of the jejunum. The needle is withdrawn and the purse string suture tied.…”

Section: Lb Over 5 Monthsmentioning

confidence: 99%

“…In 1931 Scott and Ivy105, 136 combined their respective expertise in physiology and pharmacology to devise a nutritionally complete diet designed specifically for intrajejunal feeding. The diet contained 13 ingredients with attention to vitamin and mineral content. The drawbacks of the diet were difficulty in compounding and the high content of lactose, fat, and osmotically active sucrose.…”

Section: Scott-ivy Pabulummentioning

confidence: 99%

“…Variations of this diet were used for postoperative nasojejunal feeding by groups at the University of Pennsylvania and at Bellevue. 21,11,13,96 Homogenized Milk Case et al19 popularized the use of homogenized milk as an inexpensive, readily available, and easy to use intrajejunal diet. Homogenization of the milk rendered the diet better tolerated.…”

Section: Hollander Formulamentioning

confidence: 99%

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Intrajejunal Feeding: Development and Current Status

Ryan

Page

1984

J Parenter Enteral Nutr

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Techniques of jejunostomy were established in surgical practice by the turn of the century. They were mainly used to administer normal food for the palliation of advanced gastric cancer. Standard postoperative intravenous fluid therapy did not begin in earnest until the late 1930's and did not become routine until the late 1940's because of pyrogens, fear of fluid overload, and commercial nonavailability. For most gastric procedures performed from 1900 until 1940, postoperative treatment consisted of nutrient and saline enemas and subcutaneous infusion of fluid. Jejunal feedings had their greatest use between 1930 and 1950. Gastrectomy was widely applied for cancer and ulcers in dehydrated, malnourished patients. The importance of hypoproteinemia and malnutrition on postoperative morbidity and mortality was established, and the inability of subcutaneous infusions and nutrient enemas to counteract malnutrition and dehydration was recognized. Jejunostomy or nasojejunal tubes were recommended for routine use after gastric operations. During this period, the major advances in jejunal diets and methods of feeding were accomplished. Attention was paid to assuring adequate amounts of nutrients, minerals, and vitamins, and finding diets that were easily tolerated by the jejunum. Important in these developments was the collaboration of surgeons with physiologists, gastroenterologists, pharmacologists, and members of industry. Several factors combined to reduce the use of jejunostomy after 1950. Intravenous therapy became familiar to the surgical profession, widely available, and safe. The number of gastric resections performed has decreased. Earlier referral for operation has resulted in patients with less preoperative debility and malnutrition. By 1970, total parenteral nutrition was available, and fewer jejunostomies were perceived as necessary. During the same interval, however, the increasing incidence of patients with pancreatic, esophageal, and hepatobiliary disease who faced major operations and catabolic postoperative courses presented a new challenge to the surgical community. A resurgence of concern for nutritional support, in part generated by the availability of total parenteral nutrition, prompted a renewed interest in using the gut for feeding the postoperative patient. This renewed interest, an understanding of the techniques of parenteral nutrition, the rediscovery of the gut as an absorptive surface in the postoperative patient, and the ready availability of a variety of defined formula diets have combined to rekindle the enthusiasm of many surgeons for complementary or adjuvant feeding jejunostomy.(ABSTRACT TRUNCATED AT 400 WORDS)

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Section: Lb Over 5 Monthsmentioning

confidence: 99%