• Arja Gerritsen, Ann Duflou, Max Ramali, Olivier R C Busch, Dirk J Gouma, Thomas M van Gulik, Nieveen van DijkumEls J MEJ, Elisabeth M H Mathus-Vliegen, and Marc G H Besselink.
• From the Departments of *Surgery and †Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands.
• Pancreas. 2016 Feb 1; 45 (2): 254-9.

ObjectiveAn altered anatomy such as after pancreatoduodenectomy is currently seen as relative contraindication for bedside electromagnetic (EM)-guided nasojejunal feeding tube placement. The aim of this study was to determine the feasibility and safety of bedside EM-guided placement of nasojejunal feeding tubes as compared with endoscopy in patients after pancreatoduodenectomy.MethodsWe performed a prospective monocenter pilot study in patients requiring enteral feeding after pancreatoduodenectomy (July 2012-March 2014). Primary end point was the success rate of primary tube placement confirmed on plain abdominal x-ray followed by successful enteral feeding.ResultsOverall, 53 (42%) of 126 patients who underwent pancreatoduodenectomy required a nasojejunal feeding tube, of which 36 were placed under EM guidance and, in 17, it was placed by endoscopy. Initial tube placement was successful in 21 (58%) of 36 patients with EM guidance and 9 (53%) of 17 patients with endoscopy (P = 0.71). No complications occurred during the placement procedures. Dislodgement and/or blockage of the tube occurred in 14 (39%) of 36 patients in the EM-guided group and 8 (47%) of 17 patients in the endoscopic group (P = 0.57).ConclusionsBedside EM-guided placement of nasojejunal feeding tubes by nurses was equally successful as endoscopic placement in patients after pancreatoduodenectomy.

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