From March 1980 to December 1982, at the 2nd Surgical Clinic of the University of Milan, 47
jejunostomies were performed at the conclusion of a major gastrointestinal surgery to provide immediate post-operative
enteral nutrition. A fine needle
catheter jejunostomy technique according to Delaney (10) was employed in all cases, using a
polythene catheter with an internal diameter of 2.5 mm. inserted into the proximal jejunum using a
stainless-steel needle. An elemental diet (13) was adopted and fed through a volumetric
infusion pump.
Enteral nutrition was usually initiated on the second postoperative day and on average lasted 12 days. No complications connected to positioning, permanence or removal of the
catheter were observed. The only inconvenience was represented by obstruction of the
catheter with food concretion thus feeding was discontinued in 3 patients. Collateral effects were observed in 9 patients: diarrhoea (5 cases), hyperperistaltis (2 cases), abdominal distension and
nausea (1 case). This method of nutritional intake allowed us to: maintain
body weight at pre-operative values; obtain a positive
nitrogen balance on average the sixth postoperative day; reduce the volume of parenteral support, early
suspension and a significant reduction in complications connected with this method.