Category: feeding jejunostomy
Feeding Tube with Duodenal Switch
February 03, 2025 9:53 am
The surgical changes following the revision of the failed gastric bypass to the duodenal switch or a primary duodenal switch require an evident appreciation and understanding of the anatomy and physiology of placing a feeding tube and managing the nutritional status. There are different places where a feeding tube can be placed.
1-A feeding gastrostomy tube endoscopically cannot be placed because of the transected post-pyloric duodenum (The image viewed on a desktop or a laptop allows the scroller on the image to move)
2-An orogastric or nasogastric tube should only use an elemental feeding formula. This is because the food in the stomach is prevented from mixing with the biliopancreatic juices, which will not be adequately absorbed.
3-A feeding Jejunostomy can only be insured surgical post ligament of traits. This cannot be done endoscopically because duodenal switch transaction post pyloric small bowel to prevent mixing of the biliopancreatic secretion.
Additional informationFeeding Tube
April 20, 2015 11:43 am
Feeding tubes are catheters that are placed in the lumen of the gastrointestinal tract. They are used to provide or supplement the nutritional intake. The feeding tubes can be placed in the stomach (gastrostomy tube, G-tube) or the small bowel (jejunostomy tube J-tube). Patients who are having a revision of gastric bypass, VBG, or other weight loss surgical procedure that involves the stomach in our practice will have a feeding jejunostomy placed. The reasoning behind this is that in the unlikely event of a leak, or if the patient cannot tolerate adequate water or protein early on, this provides a way of getting hydration and nutrients. In the case of a patient with a small leak drained by the drainage tubes in place, a re-operation may be avoided if adequate nutrition can be provided to the patient by the feeding tube. Given that the J tube is placed in the small bowel, the patients usually require small, frequent feeding-hydration throughout the day.
The jejunostomy tubes are easily removed in the office.
Gastrostomy tubes are placed in the stomach. They can be placed endoscopically in an intact GI tract (they can not be placed in a gastric bypass patient without taking the patient to the operating room for a surgical approach). These tubes are easy to place, and large volumes of food and hydration can be administered simultaneously.
Additional information is also available here.
Different surgeons have different practice philosophies and approaches. After the revision of hundreds of failed gastric bypasses to the duodenal switch operation, It is my opinion that the benefits of a feeding jejunostomy far outweigh the short-term care issues associated with it.
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