Percutaneous endoscopic gastro-duodenostomy: modified technique.
OBJECTIVE
Percutaneous endoscopic gastro-jejunostomy is appropriate for patients with severe neurologic deficit to avoid repeated tube feeding-related aspiration. We describe a modified technique of endoscopic gastro-duodenostomy.


METHODS
This technique was performed in 9 patients with severe neurologic deficit. No fluoroscopy was necessary. The gastrostomy button was pushed across the pylorus into the bulb; a nasogastric tube was then placed in the duodenum under endoscopic control and the button was drawn to the gastric wall. When the gastroduodenal tube migrated or was occluded, the button was placed in the bulb through the pylorus and maintained in this position for alimentation.


RESULTS
Placement of the gastro-duodenostomy tube was successful without any complication in 100% of patients. The mean duration of the procedure was 15 min. The tube had to be removed for migration (N = 4) and occlusion (N = 5) after a mean period of 5.8 weeks (range: 2-10). During the follow-up period, no tube feeding-related aspiration was observed.


CONCLUSIONS
This modified low-cost technique of endoscopic gastro-duodenostomy is simple and efficient.
Boujaoudé
Joseph
J
Service de Gastroentérologie, Hôtel Dieu de France, Université Saint Joseph, Beyrouth Liban. jbouj@hotmail.com
Hobeika
Elham
E
Nasnas
Roy
R
Khayat
Georges
G
Yazbeck
Patricia
P
Sayegh
Raymond
R
D004385:Duodenostomy / Q000379:methods*; D016145:Endoscopy, Digestive System / Q000379:methods*; D004750:Enteral Nutrition / Q000379:methods; D005774:Gastrostomy / Q000379:methods*; D006801:Humans; D009422:Nervous System Diseases / Q000150:complications