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Published in: CardioVascular and Interventional Radiology 12/2017

01-12-2017 | Technical Note

Transnasal Snare Technique for Retrograde Primary Jejunostomy Placement After Surgical Gastrojejunostomy

Authors: Rajiv N. Srinivasa, Jeffrey Forris Beecham Chick, Anthony N. Hage, James J. Shields, Wael E. Saad, Bill S. Majdalany, Ravi N. Srinivasa

Published in: CardioVascular and Interventional Radiology | Issue 12/2017

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Abstract

Purpose

To report a transnasal snare technique for retrograde primary jejunostomy placement after surgical gastrojejunostomy.

Materials and Methods

Two patients underwent the transnasal snare technique for retrograde primary jejunostomy placement. Patients included two females, age 58 and 62. In both patients, a gooseneck snare was inserted in a transnasal fashion. After insertion of the snare into the jejunum, the location was confirmed with ultrasound. The snare was then targeted using a Chiba needle through which a 0.018-inch wire was advanced and snared through the nose. The wire was exchanged for a 0.035-inch Amplatz wire over which the tract was serially dilated followed by insertion of the jejunostomy catheter through a peel-away sheath. Technical success, complications, and follow-up were recorded.

Results

Primary jejunostomy placement was technically successful in both patients. No minor or major complications occurred. Both patients received enteral nutrition the day following placement. Follow-up was at 54 and 38 days for patients 1 and 2, respectively.

Conclusion

The transnasal snare technique provides a novel alternative for primary jejunostomy insertion allowing for targeting of the jejunum with improved procedural success and no complications.
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Metadata
Title
Transnasal Snare Technique for Retrograde Primary Jejunostomy Placement After Surgical Gastrojejunostomy
Authors
Rajiv N. Srinivasa
Jeffrey Forris Beecham Chick
Anthony N. Hage
James J. Shields
Wael E. Saad
Bill S. Majdalany
Ravi N. Srinivasa
Publication date
01-12-2017
Publisher
Springer US
Published in
CardioVascular and Interventional Radiology / Issue 12/2017
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-017-1777-z

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