scholarly journals Current Considerations in Direct Percutaneous Endoscopic Jejunostomy

2012 ◽  
Vol 26 (2) ◽  
pp. 92-96 ◽  
Author(s):  
Yanfei Zhu ◽  
Liping Shi ◽  
Hao Tang ◽  
Guoqing Tao
Keyword(s):  
Percutaneous Endoscopic Gastrostomy ◽  
Enteral Feeding ◽  
Outlet Obstruction ◽  
Case Series ◽  
Success Rates ◽  
Manual Search ◽  
Extension Tube ◽  
Endoscopic Gastrostomy ◽  
Gastric Feeding ◽  
Percutaneous Endoscopic Jejunostomy

For patients who are unable to meet their nutritional needs orally, enteral feeding via a percutaneous approach has become the mainstay of therapy. However, traditional enteral feeding methods, such as percutaneous endoscopic gastrostomy, may not be viable options for patients with severe gastroparesis or gastric outlet obstruction. Direct percutaneous endoscopic jejunostomy (DPEJ) is an enteral access method that was first described more than 20 years ago and has gained popularity among gastroenterologists. This review discusses the indications for and contraindications to DPEJ, the procedure, the application of DPEJ in specific subsets of patients with gastrointestinal disorders, and presents a brief tabular summary of complications and success rates of DPEJ in case series published since 2000.BACKGROUND: Direct percutaneous endoscopic jejunostomy (DPEJ) is a well-known approach to deliver postpyloric enteral nutritional support to individuals who cannot tolerate gastric feeding. However, it is technically difficult, and some case series have reported significant procedural failure rates. The present article describes current indications, successes and complications of DPEJ placementMETHODS: A MEDLINE database search was performed to identify relevant articles using the key words “direct percutaneous endoscopic jejunostomy”, “percutaneous endoscopic gastrostomy”, and “percutaneous endoscopic gastrostomy with a jejunal extension tube”. Additional articles were identified by a manual search of the references cited in the key articles obtained in the primary search.RESULTS: DPEJ is gradually becoming more common in the treatment of patients who cannot tolerate gastric feeding. Differences in patient selection and technique modifications may contribute to the various success rates reported. Failure is most often due to inadequate transillumination or gastroduodenal obstruction. Currently, there are limited data to evaluate the safety and effectiveness of DPEJ.CONCLUSION: The clinical use of DPEJ is increasing. With appropriate care and expertise, DPEJ may prove to be reliable and safe.

scholarly journals Direct percutaneous endoscopic jejunostomy performed with gastroscope

2013 ◽  
Vol 04 (03) ◽  
pp. 090-092
Author(s):  
Ajay P. Choksi ◽  
Keyur C. Shah ◽  
Harshad K. Parekh
Keyword(s):  
Small Bowel ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Enteral Feeding ◽  
Nutritional Support ◽  
Feeding Tube ◽  
Endoscopic Gastrostomy ◽  
Gastric Feeding ◽  
Endoscopic Placement ◽  
Percutaneous Endoscopic Jejunostomy

AbstractWhile percutaneous endoscopic gastrostomy (PEG) is a well-known approach for achieving enteral feeding, direct percutaneous endoscopic jejunostomy (DPEJ) is a technique that allows endoscopic placement of percutaneous/transabdominal feeding tube directly into the jejunum. It offers a non-surgical alternative for postpyloric enteral feeding for long-term nutritional support when gastric feeding is not technically possible or is inappriopriate. Conventionally DPEJ is done with pediatric colonoscope or small bowel enteroscope. Here, we report a case where DPEJ was accomplished with gastroscope.

Endoscopic Techniques for Obtaining Enteral Access

2017 ◽  
Author(s):  
Marvin Ryou ◽  
Sanjay Salgado
Keyword(s):  
Percutaneous Endoscopic Gastrostomy ◽  
Enteral Feeding ◽  
Tube Placement ◽  
Percutaneous Endoscopic Gastrostomy Tube ◽  
Nasogastric Feeding ◽  
Percutaneous Gastrostomy ◽  
Endoscopic Techniques ◽  
Endoscopic Gastrostomy ◽  
Enteral Access ◽  
Gastric Feeding

In the absence of contraindications, enteral feeding is recommended for patients who are expected to be intolerant of oral feedings beyond 7 days. Enteral access can be accomplished by a variety of means, including surgical, endoscopic, or radiographic methods. This review focuses on endoscopy-guided options for enteral access. These methods include gastric feeding, which can be accomplished by orogastric, nasogastric, or percutaneous endoscopic gastrostomy tube placement, and postpyloric feeding, accessed through oral or nasal jejunal tubes, percutaneous gastrostomy with a jejunal extension, or direct percutaneous jejunostomy. The indications, techniques, complications, and comparative data of these placement options are outlined, and special clinical considerations (including establishing access in patients with dementia or cirrhosis and those on anticoagulation) are discussed. This review contains 5 figures, 1 table, and 33 references. Key words: direct percutaneous jejunostomy, endoscopy, enteral access in cirrhosis, enteral access in dementia, enteral feeding, enteric access, nasogastric feeding tubes, percutaneous endoscopic gastrojejunostomy tubes, percutaneous endoscopic gastrostomy tubes

scholarly journals Percutaneous Endoscopic Gastrostomy, Duodenostomy and Jejunostomy

1994 ◽  
Vol 1 (1) ◽  
pp. 37-43 ◽  
Author(s):  
Yukio Nishiguchi ◽  
Yuichi Fuyuhiro ◽  
Jae-To Lee ◽  
Soon-Myoung Kang ◽  
Mitsuru Baba ◽  
...  
Keyword(s):  
Percutaneous Endoscopic Gastrostomy ◽  
Enteral Feeding ◽  
Gastric Tube ◽  
Nutritional Support ◽  
Major Complication ◽  
Esophageal Ulcer ◽  
Great Care ◽  
Endoscopic Gastrostomy ◽  
Percutaneous Endoscopic Jejunostomy

Although enteral feeding by nasal gastric tube is popular for the patients who have a swallowing disability and require long-term nutritional support, but have intact gut, this tube sometimes causes aspiration pneumonia or esophageal ulcer. For these patients, conventional techniques for performance of a feeding gastrostomy made by surgical laparotomy have been used so far. However, these patients are frequently poor anesthetic and operative risks. Percutaneous endoscopic gastrostomy (PEG) which can be accomplished with local anesthesia and without the necessity for laparotomy has become popular in the clinical treatment for these patients. PEG was performed in 31 cases, percutaneous endoscopic duodenostomy (PED) in 1 case, and percutaneous endoscopic jejunostomy (PEJ) in 2 cases. All patients were successfully placed, and no major complication and few minor complications (9%) were experienced in this procedure. After this procedure, some patients could discharge their sputa easily and their pneumonia subsided. PED and PEJ for the patients who had previously received gastrostomy could also be done successfully with great care. Our experience suggests that PEG, PED, and PEJ are rapid, safe, and useful procedures for the patients who have poor anesthetic or poor operative risks.

Endoscopic Techniques for Obtaining Enteral Access

2017 ◽  
Author(s):  
Marvin Ryou ◽  
Sanjay Salgado
Keyword(s):  
Percutaneous Endoscopic Gastrostomy ◽  
Enteral Feeding ◽  
Tube Placement ◽  
Percutaneous Endoscopic Gastrostomy Tube ◽  
Nasogastric Feeding ◽  
Percutaneous Gastrostomy ◽  
Endoscopic Techniques ◽  
Endoscopic Gastrostomy ◽  
Enteral Access ◽  
Gastric Feeding

In the absence of contraindications, enteral feeding is recommended for patients who are expected to be intolerant of oral feedings beyond 7 days. Enteral access can be accomplished by a variety of means, including surgical, endoscopic, or radiographic methods. This review focuses on endoscopy-guided options for enteral access. These methods include gastric feeding, which can be accomplished by orogastric, nasogastric, or percutaneous endoscopic gastrostomy tube placement, and postpyloric feeding, accessed through oral or nasal jejunal tubes, percutaneous gastrostomy with a jejunal extension, or direct percutaneous jejunostomy. The indications, techniques, complications, and comparative data of these placement options are outlined, and special clinical considerations (including establishing access in patients with dementia or cirrhosis and those on anticoagulation) are discussed. This review contains 5 figures, 1 table, and 33 references. Key words: direct percutaneous jejunostomy, endoscopy, enteral access in cirrhosis, enteral access in dementia, enteral feeding, enteric access, nasogastric feeding tubes, percutaneous endoscopic gastrojejunostomy tubes, percutaneous endoscopic gastrostomy tubes

Endoscopic Techniques for Obtaining Enteral Access

2018 ◽  
Author(s):  
Marvin Ryou ◽  
Sanjay Salgado
Keyword(s):  
Percutaneous Endoscopic Gastrostomy ◽  
Enteral Feeding ◽  
Tube Placement ◽  
Percutaneous Endoscopic Gastrostomy Tube ◽  
Nasogastric Feeding ◽  
Percutaneous Gastrostomy ◽  
Endoscopic Techniques ◽  
Endoscopic Gastrostomy ◽  
Enteral Access ◽  
Gastric Feeding

In the absence of contraindications, enteral feeding is recommended for patients who are expected to be intolerant of oral feedings beyond 7 days. Enteral access can be accomplished by a variety of means, including surgical, endoscopic, or radiographic methods. This review focuses on endoscopy-guided options for enteral access. These methods include gastric feeding, which can be accomplished by orogastric, nasogastric, or percutaneous endoscopic gastrostomy tube placement, and postpyloric feeding, accessed through oral or nasal jejunal tubes, percutaneous gastrostomy with a jejunal extension, or direct percutaneous jejunostomy. The indications, techniques, complications, and comparative data of these placement options are outlined, and special clinical considerations (including establishing access in patients with dementia or cirrhosis and those on anticoagulation) are discussed. This review contains 5 figures, 1 table, and 33 references. Key words: direct percutaneous jejunostomy, endoscopy, enteral access in cirrhosis, enteral access in dementia, enteral feeding, enteric access, nasogastric feeding tubes, percutaneous endoscopic gastrojejunostomy tubes, percutaneous endoscopic gastrostomy tubes

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