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Efficacy and complications of enteral feeding tube insertion after liver transplantation.
Transplant Proc. 2015 Mar; 47(2):451-6.TP

Abstract

BACKGROUND

Adequate nutritional support for patients undergoing major surgery significantly affects postoperative recovery. Data on enteral feeding after liver transplantation (LT) are scarce. The aim of this work was to determine the efficacy and complications of feeding tubes inserted with the use of fluoroscopic assistance, endoscopic assistance, or transperitoneal jejunostomy in patients who underwent LT.

METHODS

From January 2008 to August 2013, 2,058 LTs were performed at Asan Medical Center, Seoul, Korea. Enteral feeding tubes were inserted in 155 patients (7.5%) after LT: with the use of fluoroscopic placement in 81 (52%), endoscopic placement in 49 (32%), and transperitoneal jejunostomy in 25 (16%). We retrospectively analyzed the efficacy and complications of enteral feeding tubes.

RESULTS

The median age was 55 years (interquartile range [IQR] 49-60). Enteral feeding indications were a high risk of gastric aspiration (n = 90), gastric stasis (n = 27), pneumonia (n = 23), gastrointestinal bleeding (n = 12), and bowel rest (n = 3). Median enteral feeding durations were 14.5 days (IQR 8.0-30.7) for fluoroscopic placement, 20.0 days (IQR 8.0-40.0) for endoscopic placement, and 37.5 days (IQR 18.2-86.2) for transperitoneal jejunostomy. Times to establishment of oral feeding were 13.0 days (IQR 6.2-25.7) for fluoroscopic placement, 24.0 days (IQR 10.5-43.5) for endoscopic placement, and 37.0 days (IQR 17.0-64.2) for transperitoneal jejunostomy. After tube insertion, tube dislocation and blockage occurred in 34 patients (22%) and 16 patients (25%), respectively.

CONCLUSIONS

Enteral feeding tube insertion in patients who can not maintain a nasogastric tube or start oral intake for a long time is important for nutritional support after LT. Proper feeding method selection according to patient condition can help patients by improving nutritional support after major operations such as LT.

Authors+Show Affiliations

Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Asan Digestive Disease Research Institute, Seoul, Korea.Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Asan Digestive Disease Research Institute, Seoul, Korea.Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Asan Digestive Disease Research Institute, Seoul, Korea. Electronic address: hyjung@amc.seoul.kr.Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Asan Digestive Disease Research Institute, Seoul, Korea.Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Asan Digestive Disease Research Institute, Seoul, Korea.Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Asan Digestive Disease Research Institute, Seoul, Korea.Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Asan Digestive Disease Research Institute, Seoul, Korea.Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Asan Digestive Disease Research Institute, Seoul, Korea.Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Asan Digestive Disease Research Institute, Seoul, Korea.Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Asan Digestive Disease Research Institute, Seoul, Korea.Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Asan Digestive Disease Research Institute, Seoul, Korea.Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Asan Digestive Disease Research Institute, Seoul, Korea.Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Asan Research Institute of Radiology, Seoul, Korea.Department of Liver Transplantation and Hepatobiliary Surgery, University of Ulsan College of Medicine, Asan Medical Center, Asan Research Institute of Surgery, Seoul, Korea.Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Asan Digestive Disease Research Institute, Seoul, Korea.

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

25769589

Citation

Chun, J H., et al. "Efficacy and Complications of Enteral Feeding Tube Insertion After Liver Transplantation." Transplantation Proceedings, vol. 47, no. 2, 2015, pp. 451-6.
Chun JH, Ahn JY, Jung HY, et al. Efficacy and complications of enteral feeding tube insertion after liver transplantation. Transplant Proc. 2015;47(2):451-6.
Chun, J. H., Ahn, J. Y., Jung, H. Y., Jung Park, H., Kim, G. H., Lee, J. H., Choi, K. S., Jung, K. W., Kim, D. H., Choi, K. D., Song, H. J., Lee, G. H., Kim, J. H., Song, G. W., & Kim, J. H. (2015). Efficacy and complications of enteral feeding tube insertion after liver transplantation. Transplantation Proceedings, 47(2), 451-6. https://doi.org/10.1016/j.transproceed.2014.11.035
Chun JH, et al. Efficacy and Complications of Enteral Feeding Tube Insertion After Liver Transplantation. Transplant Proc. 2015;47(2):451-6. PubMed PMID: 25769589.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy and complications of enteral feeding tube insertion after liver transplantation. AU - Chun,J H, AU - Ahn,J Y, AU - Jung,H-Y, AU - Jung Park,H, AU - Kim,G H, AU - Lee,J H, AU - Choi,K-S, AU - Jung,K W, AU - Kim,D H, AU - Choi,K D, AU - Song,H J, AU - Lee,G H, AU - Kim,J H, AU - Song,G W, AU - Kim,J-H, PY - 2014/10/02/received PY - 2014/11/04/revised PY - 2014/11/19/accepted PY - 2015/3/15/entrez PY - 2015/3/15/pubmed PY - 2015/9/18/medline SP - 451 EP - 6 JF - Transplantation proceedings JO - Transplant. Proc. VL - 47 IS - 2 N2 - BACKGROUND: Adequate nutritional support for patients undergoing major surgery significantly affects postoperative recovery. Data on enteral feeding after liver transplantation (LT) are scarce. The aim of this work was to determine the efficacy and complications of feeding tubes inserted with the use of fluoroscopic assistance, endoscopic assistance, or transperitoneal jejunostomy in patients who underwent LT. METHODS: From January 2008 to August 2013, 2,058 LTs were performed at Asan Medical Center, Seoul, Korea. Enteral feeding tubes were inserted in 155 patients (7.5%) after LT: with the use of fluoroscopic placement in 81 (52%), endoscopic placement in 49 (32%), and transperitoneal jejunostomy in 25 (16%). We retrospectively analyzed the efficacy and complications of enteral feeding tubes. RESULTS: The median age was 55 years (interquartile range [IQR] 49-60). Enteral feeding indications were a high risk of gastric aspiration (n = 90), gastric stasis (n = 27), pneumonia (n = 23), gastrointestinal bleeding (n = 12), and bowel rest (n = 3). Median enteral feeding durations were 14.5 days (IQR 8.0-30.7) for fluoroscopic placement, 20.0 days (IQR 8.0-40.0) for endoscopic placement, and 37.5 days (IQR 18.2-86.2) for transperitoneal jejunostomy. Times to establishment of oral feeding were 13.0 days (IQR 6.2-25.7) for fluoroscopic placement, 24.0 days (IQR 10.5-43.5) for endoscopic placement, and 37.0 days (IQR 17.0-64.2) for transperitoneal jejunostomy. After tube insertion, tube dislocation and blockage occurred in 34 patients (22%) and 16 patients (25%), respectively. CONCLUSIONS: Enteral feeding tube insertion in patients who can not maintain a nasogastric tube or start oral intake for a long time is important for nutritional support after LT. Proper feeding method selection according to patient condition can help patients by improving nutritional support after major operations such as LT. SN - 1873-2623 UR - https://www.unboundmedicine.com/medline/citation/25769589/Efficacy_and_complications_of_enteral_feeding_tube_insertion_after_liver_transplantation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0041-1345(15)00021-4 DB - PRIME DP - Unbound Medicine ER -