Enteral access by double-balloon enteroscopy: an alternative method of direct percutaneous endoscopic jejunostomy placement.
BACKGROUND
Although direct percutaneous endoscopic jejunal feeding tube placement is an increasingly accepted method of providing small-bowel access for long-term enteral nutrition, it is reliant on push enteroscopy and remains a technically challenging procedure with significant failure rates. Double-balloon enteroscopy, with its ability to provide controlled small-bowel intubation may facilitate direct percutaneous endoscopic jejunal tube placement.


OBJECTIVE
We report a prospective series of ten consecutive cases of double-balloon enteroscopy-assisted direct percutaneous endoscopic jejunal placement, accompanied by a step-by-step illustrated overview of the technique.


RESULTS
Direct percutaneous endoscopic jejunal tube placement by double-balloon enteroscopy was successful in nine of the ten attempted cases. In the first case, direct percutaneous endoscopic jejunal placement was abandoned due to inadequate transillumination; there were no procedure-related complications in any of our patients.


CONCLUSIONS
This first reported prospective case series of double-balloon enteroscopy-assisted direct percutaneous endoscopic jejunal placement shows a promisingly high success rate; larger comparative studies are required to clearly establish any advantages over the originally described push enteroscopy method.
Despott
E J
EJ
St. Mark's Hospital and Academic Institute, Imperial College, London, UK.
Gabe
S
S
Tripoli
E
E
Konieczko
K
K
Fraser
C
C
D000293:Adolescent; D000328:Adult; D058582:Double-Balloon Enteroscopy / Q000379:methods*; D005260:Female; D006801:Humans; D007582:Jejunostomy / Q000295:instrumentation* / Q000379:methods*; D008297:Male; D008875:Middle Aged