Laparoscopic Gastrojejunostomy Tube Placement in Infants with Congenital Cardiac Disease

Chinwendu Onwubiko, Sigrid Bairdain, Andrew J. Murphy, Maireade E. McSweeney, Julia Perkins, Rahul H. Rathod, Christopher Baird, C. Jason Smithers

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Gastrojejunostomy (GJ) tubes are an option for durable enteral access for critically ill infants with congenital cardiac disease who struggle with obtaining adequate nutrition. Materials and Methods: Infants weighing less than 10 kg with cardiac disease who received placement of a laparoscopic GJ tube from November 2011 to January 2015 were reviewed. The operative technique used an umbilical port for the camera and a single stab incision for the gastric access site. After insufflation to 5-8 mm Hg, the stomach was suspended to the abdominal wall, after which a dilator was maneuvered into a postpyloric position using laparoscopic visualization and fluoroscopy, and a glidewire was passed into the duodenum. The GJ tube was then fluoroscopically threaded over the glidewire; final position was confirmed by contrast injection. Results: There were 32 laparoscopic GJ tube placement operations performed; 7 (21.9%) of these tubes were standard single-unit GJ tubes, and 25 (78.1%) were low-profile gastrostomy tubes modified with a nasojejunal feeding tube threaded through the feeding port. Median patient age was 3.5 months (range, 0.75-11 months), with a median weight of 4.2 kg (range, 2.4-7.4 kg). Congenital defects were varied, including hypoplastic left heart syndrome and pulmonary vein stenosis. Median operative time was 62 minutes for isolated GJ placement (range, 35-114 minutes). There were three postoperative complications, resulting in a 30-day complication rate of 9.4%. Thirty-day mortality was 9.4% with no mortality related to the operation. Conclusions: Laparoscopic GJ tube placement may be performed safely in infants with cardiac disease and allows these patients to receive adequate nutrition despite intolerance of gastric feeding.

Original languageEnglish (US)
Pages (from-to)1047-1050
Number of pages4
JournalJournal of Laparoendoscopic and Advanced Surgical Techniques
Volume25
Issue number12
DOIs
StatePublished - Dec 1 2015
Externally publishedYes

ASJC Scopus subject areas

  • Surgery

Fingerprint

Dive into the research topics of 'Laparoscopic Gastrojejunostomy Tube Placement in Infants with Congenital Cardiac Disease'. Together they form a unique fingerprint.

Cite this