A jejunostomy is a specialized surgical procedure that creates a direct opening through the abdominal wall into the jejunum (the middle portion of the small intestine) for placement of a feeding tube. At our practice, we understand that the need for this specialized form of nutritional support often comes during challenging medical circumstances. That's why we're committed to providing compassionate, expert care while helping you understand each step of your treatment.
This targeted procedure effectively provides reliable nutritional access for patients who cannot use the stomach for feeding due to conditions such as gastric outlet obstruction, severe gastroesophageal reflux, gastric cancer, pancreatitis, or after certain upper gastrointestinal surgeries. Our jejunostomy approach utilizes precise surgical techniques to create a secure, functional feeding pathway directly to the small intestine. We employ meticulous tube anchoring methods and strategic placement that maximizes both nutrition absorption and patient comfort, while our comprehensive patient education program ensures the successful management of this more complex feeding system for optimal nutritional outcomes.
You may need a jejunostomy if you experience:
Inability to use the stomach for feeding due to surgery or disease
Severe gastroesophageal reflux with high aspiration risk
Gastroparesis unresponsive to medical management
Gastric outlet obstruction from tumor or stricture
After esophageal or gastric surgery requiring stomach bypass
Chronic pancreatitis requiring bowel rest
Gastric cancer affecting normal stomach function
Recurrent aspiration pneumonia despite gastrostomy feeding
Need for long-term post-pyloric feeding
Conditions requiring simultaneous gastric decompression and jejunal feeding
Esophageal or gastric varices with bleeding risk
Prior failed gastrostomy placement
Anatomical abnormalities of the upper digestive tract
Malabsorption requiring specialized feeding directly to the small intestine
Head and neck cancers with high aspiration risk
At Lifetime Surgical, our approach to jejunostomy combines precision with personalized care. The procedure begins with a comprehensive evaluation of your nutritional status, medical history, and digestive function to confirm that jejunal feeding is the optimal approach for your specific condition. Our surgeon's expertise is in both open and minimally invasive techniques, selecting the most appropriate method based on your individual circumstances and previous surgical history. Whether performing the procedure open, laparoscopically, or as part of another abdominal surgery, we locate an optimal segment of jejunum approximately 20-40 cm beyond the ligament of Treitz to ensure proper nutrient absorption.
Our distinctive approach includes creating either a direct jejunostomy (where the tube exits directly from the jejunum) or a Roux-en-Y jejunostomy (creating a segment of jejunum specifically for the tube) depending on the anticipated duration of feeding and your specific anatomy. We secure the tube with specialized purse-string sutures and precisely anchor the intestine to the abdominal wall to prevent internal leakage or tube dislodgement.
Throughout your care journey, we implement meticulous wound care protocols and specialized feeding initiation procedures that recognize the sensitive nature of direct intestinal feeding. Our multidisciplinary team includes dedicated nutritionists, nurses, and feeding specialists who provide comprehensive education tailored to the unique aspects of jejunostomy management—including proper formula selection, slower feeding rates, and specialized flushing techniques—ensuring both optimal nutrition and complication prevention for this more complex feeding access.
Immediate Post-Procedure (1-5 days)
Expect a hospital stay of 3-7 days for monitoring and careful feeding initiation
Receive specialized pain management for surgical discomfort
Begin with very slow, diluted formula infusions before gradually advancing
Monitor closely for signs of feeding intolerance like cramping or diarrhea
Learn proper positioning during continuous feedings
Work with specialized nurses to understand jejunostomy tube care
Monitor the surgical site for proper healing around the tube
Practice proper tube flushing techniques to prevent clogging
Meet with a nutritionist to establish your specific formula and rate
Receive instruction on recognizing potential complications
Prepare for discharge with specialized supplies and detailed feeding schedules
Short-Term Recovery (1-4 weeks)
Attend your follow-up appointment (typically 7-10 days after surgery)
Continue gentle care of the stoma site as it heals
Gradually increase feeding rate and concentration as tolerated
Monitor for proper wound healing and tube stability
Learn to manage common challenges like tube blockage (more common with jejunostomy tubes)
Establish a rigorous tube flushing schedule to maintain patency
Avoid submerging the site in water until fully healed (typically 3-4 weeks)
Return to light activities, avoiding heavy lifting (over 10 pounds) for 4-6 weeks
Return to work based on your surgeon's recommendation and job requirements
Adjust to the specific requirements of jejunostomy feeding:
Continuous rather than bolus feedings in many cases
More dilute formulas initially
More frequent tube flushing
Report any signs of tube displacement or feeding intolerance
Long-Term Adjustment (1-3 months)
The stoma site matures, typically within 4-6 weeks
Develop proficiency in the specialized care jejunostomy tubes require
Work with your healthcare team to optimize formula and infusion rates
Become familiar with early signs of tube complications
Return to most normal activities once the site has healed
Manage the practical aspects of continuous feeding if prescribed
Monitor weight, hydration, and nutritional parameters regularly
Learn strategies for managing tube-related issues specific to jejunostomy:
Higher risk of clogging requiring preventive measures
Careful monitoring of feeding tolerance
Specialized tube replacement procedures
Adjust to the psychological aspects of tube feeding
Develop strategies for mobility while on feeding pump if needed
Long-Term Expectations
The tube site eventually becomes well-established with a stable appearance
Smooth tissue integration at the access point with minimal complications
Improved or stabilized nutritional status despite complex digestive issues
More frequent tube replacements than with gastrostomy (typically every 2-4 months)
Adaptation to the specialized formula and feeding rates jejunostomy requires
Regular assessment of continued need and function
Potential for eventual transition to oral or gastric feeding in some conditions
Development of expertise in managing this specialized feeding route
Successful incorporation of feeding schedule into daily activities
Regular follow-up with your healthcare team to monitor overall health
Development of strategies to maintain quality of life despite feeding constraints
For permanent jejunostomy, possible consideration of a low-profile device when appropriate
Common Side Effects
Diarrhea or cramping during feeding adjustments
Small amount of drainage around the tube site
Granulation tissue formation at the stoma
More frequent tube clogging than with gastrostomy tubes
Slower advancement to goal feeding rates
Need for very regular tube maintenance and flushing
Skin irritation around the stoma site
Limitations on bolus feeding (often requiring continuous feeding)
Adjustment to specialized formulas and feeding schedules
Less Common Complications
Wound infection at the surgical site
Tube displacement or migration
Leakage of intestinal contents around the tube
Peritonitis from tube displacement
Small bowel volvulus (twisting) around the tube site
Bowel obstruction related to the jejunostomy
Internal herniation
Persistent site pain requiring medical evaluation
Fistula formation
Bleeding at the tube site requiring intervention
Surgical site infection requiring antibiotics
Inadvertent tube removal before tract maturation
Malabsorption or metabolic complications
When to Seek Immediate Medical Attention
Fever over 101°F (38.3°C)
Severe abdominal pain or increasing tenderness
Significant redness, warmth, swelling, or purulent drainage at the tube site
Tube dislodgement, especially in the first 4-6 weeks
Inability to flush the tube or administer feedings
Persistent or severe diarrhea (more than 4-6 loose stools per day)
Feeding material leaking around the tube site
Significant bleeding from the tube site
Severe bloating, abdominal distension, or vomiting
Signs of peritonitis (severe abdominal pain, rigid abdomen)
Significant change in tube position (tube appears longer or shorter)
New onset of severe cramping during feedings
Signs of dehydration despite adequate fluid provision
From your first consultation through your complete recovery, we provide:
Thorough evaluation and explanation of your condition
Clear discussion of all treatment options, including non-surgical alternatives when appropriate
Detailed pre-operative instructions to help you prepare
Compassionate care during your hospital stay or outpatient procedure
Comprehensive follow-up care and support during recovery
Ongoing availability to address questions or concerns
We understand that facing head and neck surgery can be intimidating, but you don't have to navigate this journey alone. Our team is committed to providing expert care with a personal touch, ensuring you feel supported, informed, and confident every step of the way.
Your health and wellbeing are our highest priorities, and we're honored to be part of your care team.
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All our laparoscopic procedures are performed by our highly trained surgical team using state-of-the-art equipment and techniques.
We're committed to providing you with the most advanced, minimally invasive options because we believe you deserve:
Less pain after surgery
Shorter hospital stays
Faster return to work and activities you enjoy
Smaller, less visible scars
Lower risk of complications
Better overall outcomes
Dr. Richard Nguyen is a board-certified General Surgeon with over 20 years of surgical expertise and fellowship training in Minimally Invasive and Bariatric Surgery from Vanderbilt University. Since establishing his practice in San Jose in 2007, he has pioneered innovative surgical techniques, including single-incision laparoscopic procedures and mastery of the da Vinci Robotic Surgical System. Beyond his acclaimed bariatric surgery practice, he has earned national recognition for his specialized expertise in both non-mesh and advanced mesh hernia repairs, while also serving as a critical approach surgeon for anterior spine access procedures. Dr. Nguyen combines technical precision with personalized care across multiple premier facilities throughout the South Bay Area.
I would refer Doctor Nguyen to anyone, in fact I have and they have all had the same experience as me. He is truly great. I owe all my success to Doctor Nguyen and I thank him for all the work he has done for me and continues to do so. He is extremely amazing, and I am very grateful to him.
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At 50, I now have a life I had only dreamed of a year before. My body tells me if I am done eating. This surgery is a tool that I have used to the fullest. It is not an easy way out. It still took work. But I honestly know that I would not be living this amazing new life if I didn’t step forward to embrace this life-saving surgery.
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Dr. Nguyen has changed my life completely. I feel so much better and I also feel like I’ve got control of my life again…I had high blood pressure, diabetes and cholesterol. I took at least 5 different medications for the past 30 years. NOW, after surgery I take no medications only vitamins!
Wondering which surgical procedure might be right for your condition? We're here to help you understand your treatment options and develop a personalized surgical plan. Contact our office today to schedule a consultation.
Your path to improved health may be more achievable than you think—with advanced surgical techniques leading to faster recovery, reduced complications, and a significantly enhanced quality of life.