title: Percutaneous endoscopic jejunostomy and jejunal extension tube through percutaneous endoscopic gastrostomy: a retrospective analysis of success, complications and outcome.
abstract: BACKGROUND
  Percutaneous access to the jejunum is an important approach if gastrostomy feeding is not possible.
  
  
  OBJECTIVE
  To analyze success, short- and long-term complications (STCs, LTCs) in patients with percutaneous endoscopic jejunostomy (PEJ) and jejunal access through percutaneous endoscopic gastrostomy (Jet-PEG).
  
  
  METHODS
  A retrospective analysis of endoscopically placed PEJs and Jet-PEGs. Success rates, mortality, STCs and LTCs were investigated for risk factors comprising demographic data, underlying disease, previous surgery and experience of the endoscopist.
  
  
  RESULTS
  205 PEJ and 58 Jet-PEG placements were included in the study. PEJs and Jet-PEGs were successfully placed in 65.4 and 89.7%, respectively. Billroth II surgery predisposed in favor of a significantly higher success rate for PEJ placement (p = 0.014, OR = 2.27). Inexperienced examiners have a significantly (p = 0.040) lower success rate for tube insertion than examiners with a medium level of experience. STCs and LTCs occurred evenly in PEJ and Jet-PEG patients. Dislocation of the tube occurred significantly more frequently in Jet-PEG patients (33.3%, p = 0.005). Aspiration was most common for bedridden patients.
  
  
  CONCLUSIONS
  PEJ has a significantly lower success rate for insertions, but fewer LTCs. The experience of the endoscopist correlates with the success rate of tube insertion.
authors.affiliation: Department of Medicine 1, Friedrich Alexander University Erlangen Nuremberg, Ulmenweg 18, DE-91054 Erlangen, Germany. yurdaguel.zopf@uk-erlangen.de
authors.forename: Y
authors.initials: Y
authors.lastname: Zopf
authors.forename: C
authors.initials: C
authors.lastname: Rabe
authors.forename: T
authors.initials: T
authors.lastname: Bruckmoser
authors.forename: J
authors.initials: J
authors.lastname: Maiss
authors.forename: E G
authors.initials: EG
authors.lastname: Hahn
authors.forename: D
authors.initials: D
authors.lastname: Schwab
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects; D004750:Enteral Nutrition / Q000009:adverse effects; D005260:Female; D005774:Gastrostomy / Q000009:adverse effects / Q000401:mortality; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007582:Jejunostomy / Q000009:adverse effects / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors