Percutaneous endoscopic jejunostomy: long-term follow-up of 23 patients.
This study reports our experience with the placement and long-term follow-up of 26 percutaneous endoscopic jejunostomy (PEJ) tubes in 23 patients over a 2-year period. Eighty-four percent of the PEJ tubes failed and were functional for an average of only 39.5 days. The reasons for failure were: (1) separation of the inner PEJ tube from the outer gastrostomy tube (59%); (2) clogging (32%) due to small PEJ tube diameter; and (3) kinking and knotting (9%). Upper gastrointestinal bleeding occurred in 30% of the patients (7 of 23). Only one patient required blood transfusions (2 units). The etiology of the bleeding was not determined. These patients had a previous history of acid-peptic disease and bleeding occurred despite cimetidine treatment. In contrast, only 1 of the 16 nonbleeding patients had acid-peptic disease (p less than 0.0001) and none were on cimetidine. The frequency of aspiration pneumonia decreased from 13 episodes during nasogastric tube feedings to 5 episodes during PEJ tube feedings. Improvement in the design of the PEJ tubes may increase the longevity and effectiveness of the tubes.
Kaplan
D S
DS
Department of Medicine, Veterans Administration Medical Center, Syracuse, New York.
Murthy
U K
UK
Linscheer
W G
WG
D000368:Aged; D000369:Aged, 80 and over; D004750:Enteral Nutrition / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D004868:Equipment Failure; D005069:Evaluation Studies as Topic; D005500:Follow-Up Studies; D005764:Gastroesophageal Reflux / Q000150:complications*; D006801:Humans; D007582:Jejunostomy / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011015:Pneumonia, Aspiration / Q000209:etiology / Q000517:prevention & control*