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Percutaneous endoscopic gastrojejunostomy: a dual center safety and efficacy trial.
JPEN J Parenter Enteral Nutr. 1995 May-Jun; 19(3):239-43.JJ

Abstract

Although jejunal tube placement through a percutaneous endoscopic gastrostomy (PEG) has not been proven to be preferable to PEG feeding, it would be theoretically advantageous for those patients prone to gastrointestinal aspiration. However, reliable placement of a small bowel feeding tube through a PEG has been technically difficult. We have previously reported successful placement of a percutaneous endoscopic gastrojejunostomy (PEG/J) with minimal complications. These results are in contrast to other series that report technical difficulty, frequent tube dysfunction and gastric aspiration. We describe an over-the-wire PEG/J technique performed by multiple operators at two medical centers. Gastrostomy tube placement was successful in 94% of patients. Initial placement of the jejunal tube was successful in 88% of patients. Second attempts were 100% successful. The average procedure time was 36 minutes. The distal duodenal and jejunal placement of the jejunal tube resulted in no episodes of gastroduodenal reflux. Complications included jejunal tube migration (6%), clogging (18%), and unintentional removal (11%). The majority of patients were ultimately converted to either oral or intragastric feedings. We conclude that the PEG/J system is a reliable, reproducible method of small bowel feeding and is associated with no episodes of tube feeding reflux when the jejunal tube is positioned in the distal duodenum or beyond. Furthermore, it provides a temporary nutritional bridge for those patients who are later transitioned to either PEG or oral feeding.

Authors+Show Affiliations

Section of Nutrition, Virginia Commonwealth University, Medical College of Virginia Hospitals, Richmond 23298-0711, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

8551655

Citation

DeLegge, M H., et al. "Percutaneous Endoscopic Gastrojejunostomy: a Dual Center Safety and Efficacy Trial." JPEN. Journal of Parenteral and Enteral Nutrition, vol. 19, no. 3, 1995, pp. 239-43.
DeLegge MH, Duckworth PF, McHenry L, et al. Percutaneous endoscopic gastrojejunostomy: a dual center safety and efficacy trial. JPEN J Parenter Enteral Nutr. 1995;19(3):239-43.
DeLegge, M. H., Duckworth, P. F., McHenry, L., Foxx-Orenstein, A., Craig, R. M., & Kirby, D. F. (1995). Percutaneous endoscopic gastrojejunostomy: a dual center safety and efficacy trial. JPEN. Journal of Parenteral and Enteral Nutrition, 19(3), 239-43.
DeLegge MH, et al. Percutaneous Endoscopic Gastrojejunostomy: a Dual Center Safety and Efficacy Trial. JPEN J Parenter Enteral Nutr. 1995 May-Jun;19(3):239-43. PubMed PMID: 8551655.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Percutaneous endoscopic gastrojejunostomy: a dual center safety and efficacy trial. AU - DeLegge,M H, AU - Duckworth,P F,Jr AU - McHenry,L,Jr AU - Foxx-Orenstein,A, AU - Craig,R M, AU - Kirby,D F, PY - 1995/5/1/pubmed PY - 2001/3/28/medline PY - 1995/5/1/entrez SP - 239 EP - 43 JF - JPEN. Journal of parenteral and enteral nutrition JO - JPEN J Parenter Enteral Nutr VL - 19 IS - 3 N2 - Although jejunal tube placement through a percutaneous endoscopic gastrostomy (PEG) has not been proven to be preferable to PEG feeding, it would be theoretically advantageous for those patients prone to gastrointestinal aspiration. However, reliable placement of a small bowel feeding tube through a PEG has been technically difficult. We have previously reported successful placement of a percutaneous endoscopic gastrojejunostomy (PEG/J) with minimal complications. These results are in contrast to other series that report technical difficulty, frequent tube dysfunction and gastric aspiration. We describe an over-the-wire PEG/J technique performed by multiple operators at two medical centers. Gastrostomy tube placement was successful in 94% of patients. Initial placement of the jejunal tube was successful in 88% of patients. Second attempts were 100% successful. The average procedure time was 36 minutes. The distal duodenal and jejunal placement of the jejunal tube resulted in no episodes of gastroduodenal reflux. Complications included jejunal tube migration (6%), clogging (18%), and unintentional removal (11%). The majority of patients were ultimately converted to either oral or intragastric feedings. We conclude that the PEG/J system is a reliable, reproducible method of small bowel feeding and is associated with no episodes of tube feeding reflux when the jejunal tube is positioned in the distal duodenum or beyond. Furthermore, it provides a temporary nutritional bridge for those patients who are later transitioned to either PEG or oral feeding. SN - 0148-6071 UR - https://www.unboundmedicine.com/medline/citation/8551655/Percutaneous_endoscopic_gastrojejunostomy:_a_dual_center_safety_and_efficacy_trial_ L2 - https://doi.org/10.1177/0148607195019003239 DB - PRIME DP - Unbound Medicine ER -