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Percutaneous endoscopic transgastric jejunostomy (PEG-J): a retrospective analysis on its utility in maintaining enteral nutrition after unsuccessful gastric feeding.
BMJ Open Gastroenterol. 2016; 3(1):e000098.BO

Abstract

BACKGROUND/AIMS

Although percutaneous endoscopic gastrostomy (PEG) is the method of choice for long-term enteral nutrition, feeding-related adverse events such as aspiration pneumonia and peristomal leakage can impede the use of PEG. Percutaneous endoscopic transgastric jejunostomy (PEG-J) using large-bore jejunal tubes may help by circumventing gastric passage during enteral nutrition and improving drainage of gastric secretions.

METHODS

20 patients (12 males and 8 females) who received PEG-J after unsuccessful PEG feeding during a 6-year period in our institution were analysed retrospectively to evaluate the efficacy of large-bore jejunal feeding tubes in maintaining enteral nutrition.

RESULTS

The median age was 83.5 (71-96) years. The median period between PEG and PEG-J was 33 (14-280) days. Indications were aspiration due to gastro-oesophageal reflux in 18 patients and severe peristomal leakage in 2 patients. Tube placements were successful in all patients. There were 6 (30%) in-hospital mortalities, with 3 (15%) occurring within 30 days after procedure.

CONCLUSIONS

PEG-J can be performed safely in patients with PEG and may facilitate the maintenance of enteral nutrition in most of the patients. Patients with unsuccessful PEG feeding can be offered the option of jejunal feeding before considering termination of enteral nutrition.

Authors+Show Affiliations

Department of Internal Medicine , Hiroshima Kyoritsu Hospital , Hiroshima , Japan.Endoscopy Center, Hiroshima Kyoritsu Hospital , Hiroshima , Japan.Department of Internal Medicine , Hiroshima Kyoritsu Hospital , Hiroshima , Japan.Department of Internal Medicine , Hiroshima Kyoritsu Hospital , Hiroshima , Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27486522

Citation

Toh Yoon, Ezekiel Wong, et al. "Percutaneous Endoscopic Transgastric Jejunostomy (PEG-J): a Retrospective Analysis On Its Utility in Maintaining Enteral Nutrition After Unsuccessful Gastric Feeding." BMJ Open Gastroenterology, vol. 3, no. 1, 2016, pp. e000098.
Toh Yoon EW, Yoneda K, Nakamura S, et al. Percutaneous endoscopic transgastric jejunostomy (PEG-J): a retrospective analysis on its utility in maintaining enteral nutrition after unsuccessful gastric feeding. BMJ Open Gastroenterol. 2016;3(1):e000098.
Toh Yoon, E. W., Yoneda, K., Nakamura, S., & Nishihara, K. (2016). Percutaneous endoscopic transgastric jejunostomy (PEG-J): a retrospective analysis on its utility in maintaining enteral nutrition after unsuccessful gastric feeding. BMJ Open Gastroenterology, 3(1), e000098. https://doi.org/10.1136/bmjgast-2016-000098
Toh Yoon EW, et al. Percutaneous Endoscopic Transgastric Jejunostomy (PEG-J): a Retrospective Analysis On Its Utility in Maintaining Enteral Nutrition After Unsuccessful Gastric Feeding. BMJ Open Gastroenterol. 2016;3(1):e000098. PubMed PMID: 27486522.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Percutaneous endoscopic transgastric jejunostomy (PEG-J): a retrospective analysis on its utility in maintaining enteral nutrition after unsuccessful gastric feeding. AU - Toh Yoon,Ezekiel Wong, AU - Yoneda,Kaori, AU - Nakamura,Shinya, AU - Nishihara,Kazuki, Y1 - 2016/06/27/ PY - 2016/04/29/received PY - 2016/05/19/revised PY - 2016/05/24/accepted PY - 2016/8/4/entrez PY - 2016/8/4/pubmed PY - 2016/8/4/medline KW - ENDOSCOPIC GASTROSTOMY KW - ENTERAL NUTRITION KW - NUTRITIONAL SUPPORT SP - e000098 EP - e000098 JF - BMJ open gastroenterology JO - BMJ Open Gastroenterol VL - 3 IS - 1 N2 - BACKGROUND/AIMS: Although percutaneous endoscopic gastrostomy (PEG) is the method of choice for long-term enteral nutrition, feeding-related adverse events such as aspiration pneumonia and peristomal leakage can impede the use of PEG. Percutaneous endoscopic transgastric jejunostomy (PEG-J) using large-bore jejunal tubes may help by circumventing gastric passage during enteral nutrition and improving drainage of gastric secretions. METHODS: 20 patients (12 males and 8 females) who received PEG-J after unsuccessful PEG feeding during a 6-year period in our institution were analysed retrospectively to evaluate the efficacy of large-bore jejunal feeding tubes in maintaining enteral nutrition. RESULTS: The median age was 83.5 (71-96) years. The median period between PEG and PEG-J was 33 (14-280) days. Indications were aspiration due to gastro-oesophageal reflux in 18 patients and severe peristomal leakage in 2 patients. Tube placements were successful in all patients. There were 6 (30%) in-hospital mortalities, with 3 (15%) occurring within 30 days after procedure. CONCLUSIONS: PEG-J can be performed safely in patients with PEG and may facilitate the maintenance of enteral nutrition in most of the patients. Patients with unsuccessful PEG feeding can be offered the option of jejunal feeding before considering termination of enteral nutrition. SN - 2054-4774 UR - https://www.unboundmedicine.com/medline/citation/27486522/Percutaneous_endoscopic_transgastric_jejunostomy__PEG_J_:_a_retrospective_analysis_on_its_utility_in_maintaining_enteral_nutrition_after_unsuccessful_gastric_feeding_ L2 - http://dx.doi.org/10.1136/bmjgast-2016-000098 DB - PRIME DP - Unbound Medicine ER -
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