Direct percutaneous endoscopic jejunostomies for enteral feeding Journal Article


Authors: Shike, M.; Latkany, L.; Gerdes, H.; Bloch, A. S.
Article Title: Direct percutaneous endoscopic jejunostomies for enteral feeding
Abstract: Background: Enteral feeding through percutaneous endoscopic gastrostomy (PEG) is increasingly utilized in hospitals, homes, and institutions. However, PEGs have two major limitations: (1) risk for aspiration, which occurs in up to 30% of patients, and (2) it does not allow enteral feeding in patients with gastric outlet obstruction, gastroparesis, or gastric resection. Methods: A new endoscopic method for placement of direct percutaneous endoscopic jejunostomy (DPEJ) was attempted in 150 patients with or without a history of major abdominal surgery. Patients were followed-up until tube utilization ceased because of death or resumption of oral feeding. Results: There were 129 (86%) successful procedures and 21 (14%) unsuccessful attempts. Procedure-related complications included nine (6%) insional infections. Bleeding, abscess, and colonic perforation each occurred in one patient (.6%), and all required surgical intervention. On long-term follow-up (n = 97), tube malfunction occurred in 3 patients (3%) and aspiration in 3 (3%). Duration of tube use in this population was 113 +/- 173 days. Conclusions: DPEJs can be performed successfully with a low complication rate. Enteral feeding through DPEJs drastically reduces aspiration, which commonly occurs with PEG feeding. DPEJs allow feeding and hydration of patients with gastric outlet obstruction due to cancer who are not surgical candidates, eliminate the need for intravenous hydration and feeding, and can cut costs of hospitalization and treatment.
Keywords: mortality; aspiration; complications; gastrostomy
Journal Title: Gastrointestinal Endoscopy
Volume: 44
Issue: 5
ISSN: 0016-5107
Publisher: Mosby Elsevier  
Date Published: 1996-11-01
Start Page: 536
End Page: 540
Language: English
ACCESSION: WOS:A1996VT20700005
DOI: 10.1016/s0016-5107(96)70005-6
PROVIDER: wos
PUBMED: 8934158
Notes: Article -- Source: Wos
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MSK Authors
  1. Moshe Shike
    168 Shike
  2. Hans Gerdes
    176 Gerdes
  3. Lianne M Russo
    23 Russo
  4. Abby S. Bloch
    26 Bloch