To the Editor.—Two aspects of the recent report by Delany on an improved technique for needle-catheter jejunostomy (Archives 1980;115:1235-1237) warrant comment: (1) a critical step in performing a safe needle-catheter jejunostomy is not described or illustrated, and (2) the necessity for a jejunostomy catheter larger than 16-gauge is questionable.
Although Delany's original report of the needle-catheter jejunostomy did not include attaching the jejunostomy site to the abdominal wall,1 in 1977 he enhanced the safety of the procedure by including this critical step. He added this step after observing three instances of intraperitoneal administration of solution infused through a dislodged jejunal catheter when the bowel was not sutured to the parietal peritoneum.2 The experience of myself and my colleagues3 parallels that of Delany. Using the original technique, we encountered two episodes of intraperitoneal infusion of defined formula diet after the uneventful placement and use of catheters in 35
Needle-Catheter Jejunostomy. Arch Surg. 1981;116(5):729. doi:10.1001/archsurg.1981.01380170199036