ORIGINAL ARTICLE A Clinical Study of the Morbidity Associated with the Placement of a Feeding Jejunostomy Saraansh Bansal 1 & Iqbal Singh 1 & Gaurav Maheshwari 1 & Preetinder Brar 1 & Atul Sharma Joshi 1 & Rudra Prasad Doley 1 & Rajeev Kapoor 1 & Jai Dev Wig 1 Received: 11 September 2017 /Accepted: 22 November 2017 # Association of Surgeons of India 2017 Abstract The purpose of this prospectively collected database is to evaluate the safety of placement of a feeding jejunostomy (FJ) in patients undergoing upper gastrointestinal surgery and evaluating the gastrointestinal (GI) and mechanical complications. A total of 46 consecutive patients who underwent upper gastrointestinal surgery for various benign and malignant diseases were included. All of these patients underwent Witzel feeding jejunostomy at the time of laparotomy. The patients were followed postoperatively to record the gastrointestinal and/or mechanical complications that occurred during the hospital stay of the patients. Feeding jejunostomy could be performed in 100% of the patients and postoperatively, jejunostomy feeds could be started in 97.8% of the patients. 34.8% of the patients underwent an emergency laparotomy; 81.25% of the patients in the emergency group developed a significant postoperative FJ related complications with significant mechanical complications in the emergency group. GI complications were 82.14%; diarrhea was the most frequently encountered (69.5%). GI complications were more frequent and significant in patients with a low preoperative serum albumin (< 3.5 g/dl). No mortalities were recorded as a direct consequence of a FJ. Jejunostomy feeding is an excellent method of providing enteral nutritional support in patients undergoing major abdominal surgery and in patients with upper aero digestive tract pathologies who cannot be fed by mouth. Tube feeding is associated with complications which are minor and self-limiting or can be managed by simple bedside maneu- vers. Feeding jejunostomy should be considered in all patients who may require short- or long-term enteral nutrition. Keywords Feeding jejunostomy . Enteral nutrition . Gastrointestinal surgery . Witzel Introduction Patients undergoing upper gastrointestinal surgery are at a high risk of developing malnutrition because oral intake is often interrupted. The nutritionally depleted patients are at a high risk of postoperative complications. Nutritional support is a treat- ment modality that may directly impact outcomes [1, 2]. Providing support for patient’ s postoperative nutritional re- quirements has become an important part of perioperative peri- od until they can be fed by mouth [3, 4]. The benefits of early postoperative nutritional support include early recovery and decreased complications. The current guidelines of the European Society for Parenteral and Enteral nutrition (ESPEN) recommend routine use of early enteral nutrition in patients undergoing major gastrointestinal surgery for cancer [5]. The preferred feeding strategies include nasojejunal tube feeding, jejunostomy tube feeding, and parenteral nutrition [6]. However, none of the analyzed feeding strategies in this study were found superior with respect to time to resumption of nor- mal oral intake, morbidity, and mortality. Feeding jejunal tubes provide an excellent method for postoperative enteral nutritional support [4, 7, 8]. The indi- cations for this type of feeding are increasing and include a variety of clinical conditions. Placement of a feeding jejunostomy (FJ) is often preferred during esophagectomy [3, 9], pancreaticoduodenectomy [10, 11], gastrectomy [12], pancreatic necrosectomy [13], acute corrosive injury [14], and for upper respiratory tract malignancies [15]. A potential benefit of placing a surgical jejunostomy tube is to provide a Bsafety valve^ in case of delay in resumption of oral intake. Another reason is to provide early enteral nutri- tion to reduce postoperative complications [9]. * Saraansh Bansal saraansh.bansal@gmail.com 1 Departement of General Surgery, Fortis Hospital, Mohali, Punjab, India Indian Journal of Surgery https://doi.org/10.1007/s12262-017-1709-9