Percutaneous endoscopic jejunostomy and jejunal extension tube through percutaneous endoscopic gastrostomy: a retrospective analysis of success, complications and outcome.
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.
Zopf
Y
Y
Department of Medicine 1, Friedrich Alexander University Erlangen Nuremberg, Ulmenweg 18, DE-91054 Erlangen, Germany. yurdaguel.zopf@uk-erlangen.de
Rabe
C
C
Bruckmoser
T
T
Maiss
J
J
Hahn
E G
EG
Schwab
D
D
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