Perioperative management - Catheter jejunostomy

Insertion of a jejunal feeding tube should be considered in any type of esophageal replacement surgery and also as an option in gastrectomy and transhiatal extended gastrectomy. After surgery this help to bridge any suture failure, e.g., of the esophageal anastomosis. In protracted recoveries it also offers the additional option of enteral feeding.

• On postoperative day 2 liquids may be initiated via the catheter jejunostomy with tea 30 mL/h; starting postoperative day 3 a 50:50 mixture of tea and enteral feeding solution is administered in increasing amounts.
• Once the additional enteral feeding has been terminated the percutaneous jejunal catheter can be removed. The emergence of a jejunal fistula is rare.