M H DeLegge1, P Patrick, R Gibbs. 1. Charlotte Clinic for Gastrointestinal and Liver Disease, North Carolina 28207, USA.
Abstract
OBJECTIVES: Gaining enteral access to the small bowel for patients unable to tolerate gastric feedings is a difficult challenge for today's endoscopist. A new over-the-guidewire method for placement of a percutaneous endoscopic gastrojejunostomy (PEG/J) is prospectively studied using a nonweighted, tapered tip, distal feed through jejunal tube (J-tube). METHODS: Twenty five hospitalized patients were referred to the nutrition service for enteral access. A Wilson-Cook 24/12-French PEG/J system was placed and followed until removal or patient death. RESULTS: The PEG/J system was placed in 25/25 patients in an average of 26 min and 45 s. The tip of the J-tube was in the distal duodenum in 52% of patients and in the jejunum in 48% of patients. J-tube complications occurred in 20% of patients and included one incidence of clogging (4%) and four cases of inadvertent removal (16%). Average longevity of the J-tube was 63.9 days, with most patients converted to either oral or gastric feedings. CONCLUSION: The use of an nonweighted, tapered tip J-tube and the over-the-guidewire placement technique has resulted in a reliable method of accessing the small bowel for enteral nutrition.
OBJECTIVES: Gaining enteral access to the small bowel for patients unable to tolerate gastric feedings is a difficult challenge for today's endoscopist. A new over-the-guidewire method for placement of a percutaneous endoscopic gastrojejunostomy (PEG/J) is prospectively studied using a nonweighted, tapered tip, distal feed through jejunal tube (J-tube). METHODS: Twenty five hospitalized patients were referred to the nutrition service for enteral access. A Wilson-Cook 24/12-French PEG/J system was placed and followed until removal or patient death. RESULTS: The PEG/J system was placed in 25/25 patients in an average of 26 min and 45 s. The tip of the J-tube was in the distal duodenum in 52% of patients and in the jejunum in 48% of patients. J-tube complications occurred in 20% of patients and included one incidence of clogging (4%) and four cases of inadvertent removal (16%). Average longevity of the J-tube was 63.9 days, with most patients converted to either oral or gastric feedings. CONCLUSION: The use of an nonweighted, tapered tip J-tube and the over-the-guidewire placement technique has resulted in a reliable method of accessing the small bowel for enteral nutrition.
Authors: Michael Epstein; David A Johnson; Robert Hawes; Nathan Schmulewitz; Arvydas D Vanagunas; E Roderich Gossen; Weining Z Robieson; Susan Eaton; Jordan Dubow; Krai Chatamra; Janet Benesh Journal: Clin Transl Gastroenterol Date: 2016-03-31 Impact factor: 4.488