Computed tomography-derived nasojejunal tube tip-to-gastric antrum path length and short-term outcomes in severe acute pancreatitis
Abstract
BACKGROUND: Nasojejunal (NJ) feeding is commonly used in severe acute pancreatitis (SAP), but whether deeper tube advancement improves clinical outcomes is uncertain. Computed tomography (CT)-based three-dimensional reconstruction can quantify the in-situ tube trajectory.
AIM: To determine whether CT-derived NJ tube path length is associated with short-term outcomes in patients with confirmed SAP.
METHODS: This prospective single-center observational cohort included 63 patients with confirmed SAP. CT-based three-dimensional reconstruction measured the curved path length from the gastric antrum-pylorus junction to the tube tip. The primary outcome was intensive care unit (ICU) length of stay. Associations were assessed using Spearman correlation and Acute Physiology and Chronic Health Evaluation II-adjusted median regression. Firth penalized logistic regression evaluated the exploratory composite outcome. Anatomical tube-tip position was independently classified on multiplanar CT.
RESULTS: Median path length was 17.55 cm (interquartile range, 14.35-22.27 cm). Path length was not associated with ICU stay by Spearman analysis (rho = 0.055, P = 0.671) or adjusted median regression (difference per 5-cm increase = 0.192-day, 95% confidence interval: -0.922 to 1.305, P = 0.732). Post-CT ICU stay showed a similar null association. Anatomical position was duodenal in 28 patients, at the duodenojejunal flexure in 18, and jejunal in 17; path length correlated strongly with independently measured flexure-relative distance (rho = 0.997, P < 0.001). The exploratory composite outcome occurred in 17 patients, and path length remained non-significant in Firth regression.
CONCLUSION: CT-derived NJ tube path length was not associated with ICU outcomes but closely reflected distal anatomical tube position. These findings do not establish an optimal advancement target.
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BibTeX
@article{ye2026computed,
title = {{Computed tomography-derived nasojejunal tube tip-to-gastric antrum path length and short-term outcomes in severe acute pancreatitis}},
author = {Wen Ye and Kai-Fan Xie and Yuan-Hui Zhang and Qiu-Jie Huang and Hui Yao and Jian Yang and Shi-Yang Yuan},
journal = {World journal of radiology},
year = {2026},
month = oct,
doi = {10.4329/wjr.125149},
url = {https://europepmc.org/article/PMC/PMC13720580},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Computed tomography-derived nasojejunal tube tip-to-gastric antrum path length and short-term outcomes in severe acute pancreatitis
AU - Wen Ye
AU - Kai-Fan Xie
AU - Yuan-Hui Zhang
AU - Qiu-Jie Huang
AU - Hui Yao
AU - Jian Yang
AU - Shi-Yang Yuan
PY - 2026
DA - 2026/10/28
JO - World journal of radiology
DO - 10.4329/wjr.125149
UR - https://europepmc.org/article/PMC/PMC13720580
AB - BACKGROUND: Nasojejunal (NJ) feeding is commonly used in severe acute pancreatitis (SAP), but whether deeper tube advancement improves clinical outcomes is uncertain. Computed tomography (CT)-based three-dimensional reconstruction can quantify the in-situ tube trajectory. AIM: To determine whether CT-derived NJ tube path length is associated with short-term outcomes in patients with confirmed SAP. METHODS: This prospective single-center observational cohort included 63 patients with confirmed SAP. CT-based three-dimensional reconstruction measured the curved path length from the gastric antrum-pylorus junction to the tube tip. The primary outcome was intensive care unit (ICU) length of stay. Associations were assessed using Spearman correlation and Acute Physiology and Chronic Health Evaluation II-adjusted median regression. Firth penalized logistic regression evaluated the exploratory composite outcome. Anatomical tube-tip position was independently classified on multiplanar CT. RESULTS: Median path length was 17.55 cm (interquartile range, 14.35-22.27 cm). Path length was not associated with ICU stay by Spearman analysis (rho = 0.055, P = 0.671) or adjusted median regression (difference per 5-cm increase = 0.192-day, 95% confidence interval: -0.922 to 1.305, P = 0.732). Post-CT ICU stay showed a similar null association. Anatomical position was duodenal in 28 patients, at the duodenojejunal flexure in 18, and jejunal in 17; path length correlated strongly with independently measured flexure-relative distance (rho = 0.997, P < 0.001). The exploratory composite outcome occurred in 17 patients, and path length remained non-significant in Firth regression. CONCLUSION: CT-derived NJ tube path length was not associated with ICU outcomes but closely reflected distal anatomical tube position. These findings do not establish an optimal advancement target.
SN - 1949-8470
ER -