Comparative Analysis of Laparoscopic vs Open Feeding Jejunostomy in Upper GI Disorders
Overview
This cohort study compared laparoscopic feeding jejunostomy (LFJ) with open feeding jejunostomy (OFJ) in patients with upper gastrointestinal disorders. The findings suggest that LFJ, performed with a standardized technique, offers comparable safety and postoperative complication profiles to OFJ, with potential benefits in selected operative contexts.
Background
Patients with upper gastrointestinal pathology often suffer from significant nutritional compromise due to dysphagia, tumor obstruction, and systemic effects of malignancy. Feeding jejunostomy provides reliable enteral access when oral intake is inadequate, supporting nutritional status and improving treatment tolerance. While open feeding jejunostomy is traditional, laparoscopic approaches have emerged with potential advantages including reduced morbidity and shorter hospital stays, though technical variability and limited comparative data exist.
Data Highlights
Parameter
Laparoscopic FJ (n)
Open FJ (n)
Comments
Number of procedures
Not specified
Not specified
All consecutive FJ procedures from 2018–2024 included
Operative indications
Malignant, benign, acute
Malignant, benign, acute
Both elective and emergency cases included
Complication grading
Clavien–Dindo classification used
Clavien–Dindo classification used
Postoperative complications monitored until tube removal
Key Findings
Laparoscopic feeding jejunostomy was performed using a standardized technique mirroring open principles, including Witzel tunnel construction and anti-torque sutures.
Both laparoscopic and open approaches selected the first tension-free jejunal loop for tube placement, ensuring minimal risk of volvulus.
Postoperative complications were assessed using Clavien–Dindo classification, with comparable safety profiles reported between laparoscopic and open methods.
Laparoscopic approach allowed for tailored port placement depending on whether FJ was standalone or part of a concurrent operation.
Jejunostomy tubes were maintained until oral intake was re-established, with elective outpatient removal requiring local anesthesia due to tube design.
Clinical Implications
Laparoscopic feeding jejunostomy offers a safe alternative to open jejunostomy with similar postoperative complication rates when performed using a standardized technique. Surgeons may consider LFJ particularly in elective settings or when combined with other laparoscopic procedures, potentially benefiting from minimally invasive advantages. Careful patient selection and adherence to operative principles are essential to optimize outcomes.
Conclusion
Standardized laparoscopic feeding jejunostomy is a feasible and safe approach comparable to open jejunostomy in patients with upper gastrointestinal disorders. This technique may enhance surgical versatility without compromising patient safety.
References
Author/Source/Year -- Comparative Analysis of Laparoscopic Versus Open Feeding Jejunostomy in Patients with Upper Gastrointestinal Disorders: A Cohort Study from a Single Institution
