title: One-step percutaneous gastrojejunostomy in early infancy.
abstract: In certain conditions that obviate the use of gastric feedings, the insertion of a jejunal feeding tube via gastrostomy constitutes an alternative to jejunostomy but requires a preexisting gastrostomy. Our aim was to assess a new technique of 1-step gastrojejunal tube insertion through a de novo gastrostomy. A total of 3 infants between 3 and 7 months old and weighing between 4.1 and 5.4 kg had a gastrojejunal feeding tube inserted using a 16-CH French introducer percutaneous endoscopic gastrostomy kit and a transgastric-jejunal feeding tube. No technical difficulties occurred and the gastrojejunal feeding tube was placed successfully in the 3 patients, the total procedure lasting 15 to 20 minutes. Enteral feeding was started within 4 to 6 hours of the procedure. Neither immediate (<24 hours) nor late complications related to the gastrojejunostomy occurred. Nissen fundoplication was performed in 2 of our patients at 12 and 15 months of age, respectively. The gastrojejunostomy tube was still in place in the third patient at age 15 months. Our first experience suggests that 1-step endoscopic placement of a transgastric-jejunal feeding tube without a preexisting gastrostomy tract is feasible in young and low-weight infants.
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital and Faculty of Medicine, University Lille 2, Lille, France. laurent.michaud@chru-lille.fr
authors.forename: Laurent
authors.initials: L
authors.lastname: Michaud
authors.forename: Amélie
authors.initials: A
authors.lastname: Robert-Dehault
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Coopman
authors.forename: Dominique
authors.initials: D
authors.lastname: Guimber
authors.forename: Dominique
authors.initials: D
authors.lastname: Turck
authors.forename: Frédéric
authors.initials: F
authors.lastname: Gottrand
mesh_terms: D001835:Body Weight; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D004750:Enteral Nutrition / Q000379:methods*; D018662:Fundoplication; D015390:Gastric Bypass / Q000379:methods*; D005774:Gastrostomy / Q000379:methods*; D006801:Humans; D007223:Infant; D007441:Intubation, Gastrointestinal / Q000379:methods*; D007582:Jejunostomy / Q000379:methods*; D007583:Jejunum / Q000601:surgery*; D017063:Outcome Assessment, Health Care