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A primary percutaneous (through the skin) gastrojejunostomy is a procedure in which a tube is placed through the abdominal wall into the stomach and then through the duodenum into the jejunum. Doctors in our Division of Interventional Radiology uses ultrasound and x-ray to guide the placement of the tube.
How Boston Children's Hospital approaches primary placement of percutaneous gastrojejunostomy
Our pediatric interventional radiologists, the doctors who do the procedure, are highly trained in the performance of invasive procedures on infants and children.
In addition to the interventional radiologist, your child will be cared for by a team of anesthesiologists, nurse practitioners, nurses, and technologists who specialize in caring for children undergoing interventional radiology procedures and treatments.
We perform primary percutaneous gastrojejunostomies in our suite on the second floor of the hospital, which features three procedure rooms equipped with the latest imaging technology, a recovery area for patients who have received sedation or anesthesia and examining rooms for outpatient visits.
What is a primary placed percutaneous gastrojejunostomy?
A primary percutaneous gastrojejunostomy tube is placed into your child's stomach as a means of feeding when he is unable to eat or tolerate oral or gastric feeds. The tube is placed into his stomach through the abdominal wall. The placement of the tube is done under image guidance, which means that images or pictures taken through ultrasound and x-ray are used to guide the placement of the tube.
The primary gastrojejunostomytube is usually placed under sedation or general anesthesia.
When might a primary percutaneous gastrojejunostomy be needed?
How should I prepare my child for a primary percutaneous gastrojejunostomy?
Some children may need to have an appointment in the pre-op clinic:
Your child may receive general anesthesia to help him stay still during the procedure. General anesthesia is medicine that causes deep sleep. The anesthesiologist will discuss this with you and obtain consent, either the day of the procedure or at a scheduled pre-operative visit.
Explain in simple terms why the procedure is needed and what will happen.
All patients are admitted to the hospital after the procedure to start feeds. You can anticipate at least a 48 hours admission.
What should I expect when I bring my child to the hospital for a primary percutaneous gastrojejunostomy?
You will be instructed by the day surgery nurse or at the time of your pre-op visit
The interventional radiologist will explain the procedure to you and your child. Before the procedure begins, you must sign a consent form. You must be your child's legal guardian to sign this form. If you are a legal guardian and not a parent, you must bring legal paperwork with you showing proof of legal guardianship.
What happens during a primary percutaneous gastrojejunostomy?
The procedure will take approximately two to three hours.
What happens after the primary percutaneous gastrojejunostomy?
Is a primary percutaneous gastrojejunostomy safe?
Primary percutaneous gastrojejunostomy, when performed by an appropriately trained and experienced interventional radiologist, is a safe procedure which can usually be performed under sedation or general anesthesia. As with all invasive procedures, complications and side effects may occur. These will be explained to you in detail before you give your consent.
Your child will be exposed to ionizing radiation (x-rays) during the procedure. We believe that the benefit to your child's health outweighs the exposure that occurs during the primary percutaneous gastrojejunostomy. Because children are more sensitive to radiation exposure than adults, we have been leaders in adjusting equipment and procedures to deliver the lowest possible dose to young patients.
How do I learn the results of the primary percutaneous gastrojejunostomy?
The interventional radiologist will inform you of the results immediately after the procedure. If you have any questions, please speak to your child's doctor.
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