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Background Nasojejunal (NJ) feeding tubes can be inserted endoscopically for short term post pyloric feeding for a period of up to 90 days. The project aim was to evaluate all NJ insertion procedures performed in the trust to identify features associated with successful tube insertion, rates of reinsertion and post procedure outcomes.Method Endoscopy reporting software was used to identify gastroscopy procedures performed between 1 January and 31 December 2024 where NJ was listed as an indication or therapy. Indication, procedure details were recorded and post insertion outcomes including tube failure (blockage or dislodgement) after 72 hours and the need for reinsertion at 7 days, 30 days, or 3 months (the tube lifespan) were taken from electronic patient records.Results 280 procedures were analysed and successful NJ tube insertion at the time of procedure was recorded in 269/280 (96%). Indications included malignant strictures (34%), functional conditions (10%), pancreatitis (32%) or other benign indications (25%). 239/280(86%) were performed under conscious sedation (median fentanyl 50 mcg, midazolam 2 mg).Tube insertion length was documented in 238/269 (89%) and median insertion length was 110cm, with range 60-180cm. 33/238 (14%) were inserted <90cm, 107/238 (45%) were inserted between 90-110cm and 98/238 (41%) were over 110cm. Tubes inserted to lengths between 90-110cm less commonly failed within 72hours (85%) and did not require reinsertion (63%), compared to tubes inserted <90cm (85% and 39%) or >110cm (76% and 50%). Detailed outcomes are shown in table 1.182/269 (68%) procedures had a documented post insertion flush, with a follow up AXR performed in 23/269 (8.5%). Tubes flushed after insertion failed within 72 hours less often than those not flushed (16% vs 28%).Discussion NJ tubes are inserted for various indications with a high success rate. A quarter of tubes inserted over 110 cm failed within 72 hours more commonly than tubes at shorter lengths, likely due to coiling. Tubes inserted at 90–110cm required reinsertion less often, suggesting an optimal length to minimise problems. Flushing tubes immediately after insertion was observed to have lower early failure rates, which may provide real-time information on tube patency.Overall, these findings suggest an optimal insertion length of 90–110 cm, with routine length documentation and post insertion flushing potentially supporting best practice. Local reaudit is planned after these recommendations are implemented.Abstract P293 Table 1Tube length<90cm(%)N = 3390-110cm(%)N = 107>110cm(%)N = 98Tube failure within 72 hoursNo858576Yes, non-endoscopically resolved0810Yes, required endoscopic resolution15714ReinsertionNot required396350Within 7 days181119Within 30 days301821Within 3 months1289