title: Percutaneous endoscopic gastrojejunostomy with a tapered tip, nonweighted jejunal feeding tube: improved placement success.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.affiliation: Charlotte Clinic for Gastrointestinal and Liver Disease, North Carolina 28207, USA.
authors.forename: M H
authors.initials: MH
authors.lastname: DeLegge
authors.forename: P
authors.initials: P
authors.lastname: Patrick
authors.forename: R
authors.initials: R
authors.lastname: Gibbs
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019723:Endoscopes; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D004750:Enteral Nutrition / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D005774:Gastrostomy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D007582:Jejunostomy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D013997:Time Factors