Witzel Versus Stamm-Like Technique in Laparoscopic Feeding Jejunostomy: A Comparative Analysis of Complications.

Abstract

Feeding jejunostomy (FJ) is a key procedure to ensure proper nutrition in complex gastrointestinal surgeries and upper gastrointestinal (GI) obstruction. Over time, many techniques have been employed. In our unit, the preferred technique was Stamm's. Following an observed increase in jejunostomy-related complications, a Witzel-type approach was adopted. The aim of this article is to compare jejunostomy-related complications between both techniques. This retrospective study includes all laparoscopic feeding jejunostomies performed from January 2023 until October 2025. Patients were divided into two groups according to the technique that was used for the laparoscopic jejunostomy. Variables registered were demographics and complications related specifically to jejunostomy at 30-day follow-up. There were a total of 96 patients, 40 performed using Stamm's technique and 56 with Witzel's. In the Stamm-like group, 8 patients (20%) developed adverse events related to the jejunostomy. In the Witzel group, 2 patients had a jejunostomy related complication (3.6%) (p = 0.009). Even when part of a more complex procedure, feeding jejunostomy should not be overlooked. Patients' nutritional support often depends on it. When adverse events occur, they may prolong hospitalization and delay oncological treatment. In our cohort, Witzel's technique presented significantly fewer complications.