scholarly journals Percutaneous Endoscopic Gastrostomy, Duodenostomy and Jejunostomy

1994 ◽  
Vol 1 (1) ◽  
pp. 37-43 ◽  
Author(s):  
Yukio Nishiguchi ◽  
Yuichi Fuyuhiro ◽  
Jae-To Lee ◽  
Soon-Myoung Kang ◽  
Mitsuru Baba ◽  
...  

Although enteral feeding by nasal gastric tube is popular for the patients who have a swallowing disability and require long-term nutritional support, but have intact gut, this tube sometimes causes aspiration pneumonia or esophageal ulcer. For these patients, conventional techniques for performance of a feeding gastrostomy made by surgical laparotomy have been used so far. However, these patients are frequently poor anesthetic and operative risks. Percutaneous endoscopic gastrostomy (PEG) which can be accomplished with local anesthesia and without the necessity for laparotomy has become popular in the clinical treatment for these patients. PEG was performed in 31 cases, percutaneous endoscopic duodenostomy (PED) in 1 case, and percutaneous endoscopic jejunostomy (PEJ) in 2 cases. All patients were successfully placed, and no major complication and few minor complications (9%) were experienced in this procedure. After this procedure, some patients could discharge their sputa easily and their pneumonia subsided. PED and PEJ for the patients who had previously received gastrostomy could also be done successfully with great care. Our experience suggests that PEG, PED, and PEJ are rapid, safe, and useful procedures for the patients who have poor anesthetic or poor operative risks.

2013 ◽  
Vol 04 (03) ◽  
pp. 090-092
Author(s):  
Ajay P. Choksi ◽  
Keyur C. Shah ◽  
Harshad K. Parekh

AbstractWhile percutaneous endoscopic gastrostomy (PEG) is a well-known approach for achieving enteral feeding, direct percutaneous endoscopic jejunostomy (DPEJ) is a technique that allows endoscopic placement of percutaneous/transabdominal feeding tube directly into the jejunum. It offers a non-surgical alternative for postpyloric enteral feeding for long-term nutritional support when gastric feeding is not technically possible or is inappriopriate. Conventionally DPEJ is done with pediatric colonoscope or small bowel enteroscope. Here, we report a case where DPEJ was accomplished with gastroscope.


2018 ◽  
Vol 5 (10) ◽  
pp. 3282 ◽  
Author(s):  
Ann Sunny ◽  
Venkatanarasimhan N. S. ◽  
Anil Kumar

Background: Patients who are unable to consume orally often require some form of nutritional support. Enteral is always better than the parenteral route. Enteral feeds via traditional nasogastric tube or nasojejunal route have been used for short term feeding but for long term management of these patients percutaneous endoscopic gastrostomy is a better option. It does not require an operating room and has less morbidity associated with it.Methods: We did a prospective descriptive study to look at the role of percutaneous endoscopic gastrostomy (PEG) in providing nutritional support to patients and the morbidity associated with this procedure.Results: In this study, 83% of the patients needed PEG for head and neck cancers prior to radiotherapy and chemotherapy. Most of our patients had no complications due to the procedure (70%). There was only one major complication of necrotizing fasciitis, the rest were all minor complications. The nutritional parameters checked at the beginning and at the end of the study were not statistically significant, for example weight, serum albumin and hemoglobin but all these parameters of the study patients were stable.Conclusions: Authors found that long-term enteral feeding via PEG is a safe, effective, easy-to-apply, and highly acceptable method with minimal complications.


2012 ◽  
Vol 26 (2) ◽  
pp. 92-96 ◽  
Author(s):  
Yanfei Zhu ◽  
Liping Shi ◽  
Hao Tang ◽  
Guoqing Tao

For patients who are unable to meet their nutritional needs orally, enteral feeding via a percutaneous approach has become the mainstay of therapy. However, traditional enteral feeding methods, such as percutaneous endoscopic gastrostomy, may not be viable options for patients with severe gastroparesis or gastric outlet obstruction. Direct percutaneous endoscopic jejunostomy (DPEJ) is an enteral access method that was first described more than 20 years ago and has gained popularity among gastroenterologists. This review discusses the indications for and contraindications to DPEJ, the procedure, the application of DPEJ in specific subsets of patients with gastrointestinal disorders, and presents a brief tabular summary of complications and success rates of DPEJ in case series published since 2000.BACKGROUND: Direct percutaneous endoscopic jejunostomy (DPEJ) is a well-known approach to deliver postpyloric enteral nutritional support to individuals who cannot tolerate gastric feeding. However, it is technically difficult, and some case series have reported significant procedural failure rates. The present article describes current indications, successes and complications of DPEJ placementMETHODS: A MEDLINE database search was performed to identify relevant articles using the key words “direct percutaneous endoscopic jejunostomy”, “percutaneous endoscopic gastrostomy”, and “percutaneous endoscopic gastrostomy with a jejunal extension tube”. Additional articles were identified by a manual search of the references cited in the key articles obtained in the primary search.RESULTS: DPEJ is gradually becoming more common in the treatment of patients who cannot tolerate gastric feeding. Differences in patient selection and technique modifications may contribute to the various success rates reported. Failure is most often due to inadequate transillumination or gastroduodenal obstruction. Currently, there are limited data to evaluate the safety and effectiveness of DPEJ.CONCLUSION: The clinical use of DPEJ is increasing. With appropriate care and expertise, DPEJ may prove to be reliable and safe.


2002 ◽  
Vol 21 (1) ◽  
pp. 27-31 ◽  
Author(s):  
H. CORTEZ-PINTO ◽  
A. PINTO CORREIA ◽  
M.E. CAMILO ◽  
L. TAVARES ◽  
M.CARNEIRO DE MOURA

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