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Short- and long-term outcomes from percutaneous endoscopic gastrostomy with jejunal extension.
Surg Endosc. 2017 07; 31(7):2901-2909.SE

Abstract

BACKGROUND

There is a paucity of data regarding the safety and efficacy of percutaneous endoscopic gastrostomy with jejunal extension (PEG-J). We evaluated adverse events related to PEG-J and determined the clinical impact of PEG-J in those with chronic pancreatitis (CP).

METHODS

This cohort study included all patients who underwent PEG-J placement in a tertiary-care academic medical center between 2010 and 2012. Main outcome measurements were (1) short- and long-term complications related to PEG-J and (2) changes in weight and hospitalizations during the 12-month period before and after PEG-J in the CP subgroup.

RESULTS

Of 102 patients undergoing PEG-J placement, the overall technical success rate was 97 %. During a median follow-up period of 22 months (1-46 months, n = 90), at least one tube malfunction occurred in 52/90 (58 %; 177 episodes) after a median of 53 days (3-350 days), requiring a median of two tube replacements. Short-term (<30 days) tube malfunction occurred in 28/90 (31 %) and delayed in 24/90 (27 %); these included dislodgement (29 %), clogging (26 %) and kinking (14 %). In the CP subgroup (n = 58), mean body weight (kg) (70 vs. 71, p = 0.06) and body mass index (kg/m2, 26 vs. 27, p = 0.05) increased post-PEG-J. Mean number of hospitalizations (5 vs. 2, p < 0.0001) and inpatient days per 12 months (22 vs. 12, p = 0.005) decreased.

CONCLUSIONS

While we observed no major complications related to PEG-J, half of patients had at least one episode of tube malfunction. In the CP subgroup, jejunal feeding via PEG-J significantly reduced the number of hospitalizations and inpatients days, while improving nutritional parameters.

Authors+Show Affiliations

Indiana University School of Medicine, Indianapolis, IN, USA. King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Chulalongkorn University, Bangkok, Thailand.Indiana University School of Medicine, Indianapolis, IN, USA.Indiana University School of Medicine, Indianapolis, IN, USA.Indiana University School of Medicine, Indianapolis, IN, USA.Indiana University School of Medicine, Indianapolis, IN, USA.Indiana University School of Medicine, Indianapolis, IN, USA.Indiana University School of Medicine, Indianapolis, IN, USA. cotea@musc.edu. Medical University of South Carolina, 114 Doughty Street, MSC 702, Room 249, Charleston, SC, 29425, USA. cotea@musc.edu.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27796601

Citation

Ridtitid, Wiriyaporn, et al. "Short- and Long-term Outcomes From Percutaneous Endoscopic Gastrostomy With Jejunal Extension." Surgical Endoscopy, vol. 31, no. 7, 2017, pp. 2901-2909.
Ridtitid W, Lehman GA, Watkins JL, et al. Short- and long-term outcomes from percutaneous endoscopic gastrostomy with jejunal extension. Surg Endosc. 2017;31(7):2901-2909.
Ridtitid, W., Lehman, G. A., Watkins, J. L., McHenry, L., Fogel, E. L., Sherman, S., & Coté, G. A. (2017). Short- and long-term outcomes from percutaneous endoscopic gastrostomy with jejunal extension. Surgical Endoscopy, 31(7), 2901-2909. https://doi.org/10.1007/s00464-016-5301-3
Ridtitid W, et al. Short- and Long-term Outcomes From Percutaneous Endoscopic Gastrostomy With Jejunal Extension. Surg Endosc. 2017;31(7):2901-2909. PubMed PMID: 27796601.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Short- and long-term outcomes from percutaneous endoscopic gastrostomy with jejunal extension. AU - Ridtitid,Wiriyaporn, AU - Lehman,Glen A, AU - Watkins,James L, AU - McHenry,Lee, AU - Fogel,Evan L, AU - Sherman,Stuart, AU - Coté,Gregory A, Y1 - 2016/10/28/ PY - 2016/09/04/received PY - 2016/10/14/accepted PY - 2016/11/1/pubmed PY - 2018/2/24/medline PY - 2016/11/1/entrez KW - Chronic pancreatitis KW - Enteral feeding KW - Enteral nutrition KW - Percutaneous endoscopic gastrostomy with jejunal extension SP - 2901 EP - 2909 JF - Surgical endoscopy JO - Surg Endosc VL - 31 IS - 7 N2 - BACKGROUND: There is a paucity of data regarding the safety and efficacy of percutaneous endoscopic gastrostomy with jejunal extension (PEG-J). We evaluated adverse events related to PEG-J and determined the clinical impact of PEG-J in those with chronic pancreatitis (CP). METHODS: This cohort study included all patients who underwent PEG-J placement in a tertiary-care academic medical center between 2010 and 2012. Main outcome measurements were (1) short- and long-term complications related to PEG-J and (2) changes in weight and hospitalizations during the 12-month period before and after PEG-J in the CP subgroup. RESULTS: Of 102 patients undergoing PEG-J placement, the overall technical success rate was 97 %. During a median follow-up period of 22 months (1-46 months, n = 90), at least one tube malfunction occurred in 52/90 (58 %; 177 episodes) after a median of 53 days (3-350 days), requiring a median of two tube replacements. Short-term (<30 days) tube malfunction occurred in 28/90 (31 %) and delayed in 24/90 (27 %); these included dislodgement (29 %), clogging (26 %) and kinking (14 %). In the CP subgroup (n = 58), mean body weight (kg) (70 vs. 71, p = 0.06) and body mass index (kg/m2, 26 vs. 27, p = 0.05) increased post-PEG-J. Mean number of hospitalizations (5 vs. 2, p < 0.0001) and inpatient days per 12 months (22 vs. 12, p = 0.005) decreased. CONCLUSIONS: While we observed no major complications related to PEG-J, half of patients had at least one episode of tube malfunction. In the CP subgroup, jejunal feeding via PEG-J significantly reduced the number of hospitalizations and inpatients days, while improving nutritional parameters. SN - 1432-2218 UR - https://www.unboundmedicine.com/medline/citation/27796601/Short__and_long_term_outcomes_from_percutaneous_endoscopic_gastrostomy_with_jejunal_extension_ L2 - https://doi.org/10.1007/s00464-016-5301-3 DB - PRIME DP - Unbound Medicine ER -