Frequency and outcomes of gastrojejunostomy tube replacement in children - a single-centre experience.

Background: At present, there is no consensus on whether gastrojejunostomy tubes should be routinely changed and if so, on what timescale.

Objective: We describe our 5-year experience following the 2018 introduction of an interventional radiology lead service of four to six monthly elective changes. We focused on the impact this had on the number and length of hospital admissions, and radiation dose.

Materials and methods: Retrospective review of gastrojejunostomy tube exchanges performed from 2011-2022 in a single centre.

Results: Over 11 years, 89 gastrojejunostomy tube exchanges were performed in ten patients. Following the introduction of the interventional radiology-led elective service in 2018, 50 gastrojejunostomy tube exchanges were done electively vs 25 done as emergencies. On average, gastrojejunostomy tubes were replaced every 5.6 months (elective 6.4 months, emergency 3.3 months). The median was 4 months. The most cited reasons for an emergency replacement were a malfunctioning tube or displaced tube. General anaesthetic was required for 61 exchanges. Admission time was shorter for elective exchanges (1.2 days vs 3.1 days). There was no significant difference in the average dose area product for elective vs emergency procedures.

Conclusion: Our results suggest that an optimal time for gastrojejunostomy tube replacement is 4 months. Elective replacement of gastrojejunostomy tubes results in a reduced number and length of admissions.