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Success rate of direct percutaneous endoscopic jejunostomy in patients who are obese.
Gastrointest Endosc. 2008 Feb; 67(2):265-9.GE

Abstract

BACKGROUND

Direct percutaneous endoscopic jejunostomy (DPEJ) is increasingly used as a method for obtaining jejunal enteral access. The most cited reason of unsuccessful placement is poor transillumination, which may be related to obesity. Whether obesity affects failure and complication rates has not been previously described.

OBJECTIVE

To compare the success rate and adverse events (AEs) associated with DPEJ placement in patients who were overweight and patients who were obese compared with patients who were normal or underweight defined by body mass index (BMI).

DESIGN

Retrospective database review.

SETTING

A tertiary-referral center.

PATIENTS

Eighty DPEJ placements between February 2000 and September 2005.

MAIN OUTCOME MEASUREMENTS

DPEJ placement success in patients who were overweight/obese (BMI >or= 25) versus patients who were normal or underweight (BMI <25). Secondary end points included procedure time and AEs.

RESULTS

Eighty DPEJs were placed in 75 patients. Of these DPEJs, 65 (81%) succeeded and 15 (19%) failed. Success rates were 23 of 24 for patients who were underweight (96%), 25 of 31 for patients with normal BMI (81%), 8 of 11 for patients who were overweight (73%), and 6 of 10 for persons who were obese (60%) (odds ratio 3.43, 95% CI 1.03-11.44; P< .05 for BMI >or= 25 vs BMI<25). Overall, AEs were not significantly different for patients with BMI <25 versus BMI >or=25 (24/55 vs 9/21, respectively; P= .64). However, 4 of the 5 severe AEs occurred in patients with a BMI >or= 25 (P= .07).

LIMITATIONS

Retrospective single center.

CONCLUSIONS

DPEJ placement in patients who were overweight or obese was feasible, but procedural success was less frequent, and a trend toward more frequent major AEs was seen than in persons with normal or decreased BMI. BMI was an easily assessed preprocedural factor for DPEJ success and complication rates.

Authors+Show Affiliations

Division of Gastroenterology, University of Utah, Salt Lake City, Utah 84132, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

17996236

Citation

Mackenzie, Scott H., et al. "Success Rate of Direct Percutaneous Endoscopic Jejunostomy in Patients Who Are Obese." Gastrointestinal Endoscopy, vol. 67, no. 2, 2008, pp. 265-9.
Mackenzie SH, Haslem D, Hilden K, et al. Success rate of direct percutaneous endoscopic jejunostomy in patients who are obese. Gastrointest Endosc. 2008;67(2):265-9.
Mackenzie, S. H., Haslem, D., Hilden, K., Thomas, K. L., & Fang, J. C. (2008). Success rate of direct percutaneous endoscopic jejunostomy in patients who are obese. Gastrointestinal Endoscopy, 67(2), 265-9.
Mackenzie SH, et al. Success Rate of Direct Percutaneous Endoscopic Jejunostomy in Patients Who Are Obese. Gastrointest Endosc. 2008;67(2):265-9. PubMed PMID: 17996236.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Success rate of direct percutaneous endoscopic jejunostomy in patients who are obese. AU - Mackenzie,Scott H, AU - Haslem,Derrick, AU - Hilden,Kristen, AU - Thomas,Kristen L, AU - Fang,John C, Y1 - 2007/11/08/ PY - 2007/02/07/received PY - 2007/06/18/accepted PY - 2007/11/13/pubmed PY - 2008/4/5/medline PY - 2007/11/13/entrez SP - 265 EP - 9 JF - Gastrointestinal endoscopy JO - Gastrointest Endosc VL - 67 IS - 2 N2 - BACKGROUND: Direct percutaneous endoscopic jejunostomy (DPEJ) is increasingly used as a method for obtaining jejunal enteral access. The most cited reason of unsuccessful placement is poor transillumination, which may be related to obesity. Whether obesity affects failure and complication rates has not been previously described. OBJECTIVE: To compare the success rate and adverse events (AEs) associated with DPEJ placement in patients who were overweight and patients who were obese compared with patients who were normal or underweight defined by body mass index (BMI). DESIGN: Retrospective database review. SETTING: A tertiary-referral center. PATIENTS: Eighty DPEJ placements between February 2000 and September 2005. MAIN OUTCOME MEASUREMENTS: DPEJ placement success in patients who were overweight/obese (BMI >or= 25) versus patients who were normal or underweight (BMI <25). Secondary end points included procedure time and AEs. RESULTS: Eighty DPEJs were placed in 75 patients. Of these DPEJs, 65 (81%) succeeded and 15 (19%) failed. Success rates were 23 of 24 for patients who were underweight (96%), 25 of 31 for patients with normal BMI (81%), 8 of 11 for patients who were overweight (73%), and 6 of 10 for persons who were obese (60%) (odds ratio 3.43, 95% CI 1.03-11.44; P< .05 for BMI >or= 25 vs BMI<25). Overall, AEs were not significantly different for patients with BMI <25 versus BMI >or=25 (24/55 vs 9/21, respectively; P= .64). However, 4 of the 5 severe AEs occurred in patients with a BMI >or= 25 (P= .07). LIMITATIONS: Retrospective single center. CONCLUSIONS: DPEJ placement in patients who were overweight or obese was feasible, but procedural success was less frequent, and a trend toward more frequent major AEs was seen than in persons with normal or decreased BMI. BMI was an easily assessed preprocedural factor for DPEJ success and complication rates. SN - 0016-5107 UR - https://www.unboundmedicine.com/medline/citation/17996236/Success_rate_of_direct_percutaneous_endoscopic_jejunostomy_in_patients_who_are_obese_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0016-5107(07)02224-9 DB - PRIME DP - Unbound Medicine ER -