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Percutaneous Endoscopic Gastrojejunostomy: A Dual Center Safety and Efficacy Trial
Author(s) -
Delegge Mark H.,
Duckworth P. Frederick,
Mchenry Lee,
FoxxOrenstein Amy,
Craig Robert M.,
Kirby Donald F.
Publication year - 1995
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607195019003239
Subject(s) - medicine , percutaneous endoscopic gastrostomy , parenteral nutrition , feeding tube , gastrostomy , duodenum , peg ratio , enteral administration , surgery , reflux , intubation , tube (container) , jejunum , percutaneous , mechanical engineering , disease , finance , engineering , economics
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. (Journal of Parenteral and Enteral Nutrition 19:239–243, 1995)