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December 1961

Further Experiences with Jejunal Gastrostomy

Author Affiliations

From the Department of Surgery, University of Washington School of Medicine (Associate Professor, Dr. Nyhus; Assistant Resident, Dr. McDade; Assistant in Surgery, Dr. Condon; Assistant Professor, Dr. Stevenson; Professor and Executive Officer, Dr. Harkins).

Arch Surg. 1961;83(6):864-868. doi:10.1001/archsurg.1961.01300180064011

An ideal permanent gastrostomy should allow for simple administration of food and also should prevent the reflux of food or the leakage of acid gastric chyme onto the anterior abdominal wall. Having become discouraged with many of the usual gastrostomy methods, particularly as related to the reflux of acid gastric chyme (Fig. 1), we sought a new method which would have the advantages of an ideal gastrostomy.

Merendino and Dillard (1955) used an isolated loop of jejunum as a substitute sphincter between esophagus and stomach. One of the outstanding features of this operation has been the prevention of gastroesophageal reflux due, apparently, to the peristaltic action of the jejunal loop. It seemed to us that such a loop had a potential quality that would be useful in the construction of a permanent gastrostomy. On the basis of these considerations, a technique evolved using an isolated loop of jejunum between the