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September 1986

Jejunostomy: An Indicated Procedure?

Arch Surg. 1986;121(9):1095. doi:10.1001/archsurg.1986.01400090127025

To the Editor.—In a recent issue, Adams et al1 reported on their limited experience with 73 patients undergoing jejunostomy during a 15-year period. They concluded, based on this limited experience with high-risk patients, that jejunostomy is a rarely indicated procedure. I take strong exception to this point of view. The patients they described were obviously at high risk since 29 of these patients died during hospitalization. Since our complication rate remains at less than 1% with large numbers of patients of all ages, one would obviously have to assume that the patients of Adams et al constituted an extremely high-risk group. In addition, they reported aspiration as a significant complication, although 16 of their patients had a prior history of aspiration, and 14 patients were comatose at the time of jejunostomy. No mention of the incidence of gastroesophageal (GE) reflux was reported. Since it is well known that

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