title: Percutaneous endoscopic transgastric jejunostomy (PEG-J): a retrospective analysis on its utility in maintaining enteral nutrition after unsuccessful gastric feeding.
abstract: Although percutaneous endoscopic gastrostomy (PEG) is the method of choice for long-term enteral nutrition, feeding-related adverse events such as aspiration pneumonia and peristomal leakage can impede the use of PEG. Percutaneous endoscopic transgastric jejunostomy (PEG-J) using large-bore jejunal tubes may help by circumventing gastric passage during enteral nutrition and improving drainage of gastric secretions.
  
  
  
  20 patients (12 males and 8 females) who received PEG-J after unsuccessful PEG feeding during a 6-year period in our institution were analysed retrospectively to evaluate the efficacy of large-bore jejunal feeding tubes in maintaining enteral nutrition.
  
  
  
  The median age was 83.5 (71-96) years. The median period between PEG and PEG-J was 33 (14-280) days. Indications were aspiration due to gastro-oesophageal reflux in 18 patients and severe peristomal leakage in 2 patients. Tube placements were successful in all patients. There were 6 (30%) in-hospital mortalities, with 3 (15%) occurring within 30 days after procedure.
  
  
  
  PEG-J can be performed safely in patients with PEG and may facilitate the maintenance of enteral nutrition in most of the patients. Patients with unsuccessful PEG feeding can be offered the option of jejunal feeding before considering termination of enteral nutrition.
authors.affiliation: Department of Internal Medicine , Hiroshima Kyoritsu Hospital , Hiroshima , Japan.
authors.forename: Ezekiel Wong
authors.initials: EW
authors.lastname: Toh Yoon
authors.affiliation: Endoscopy Center, Hiroshima Kyoritsu Hospital , Hiroshima , Japan.
authors.forename: Kaori
authors.initials: K
authors.lastname: Yoneda
authors.affiliation: Department of Internal Medicine , Hiroshima Kyoritsu Hospital , Hiroshima , Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Nakamura
authors.affiliation: Department of Internal Medicine , Hiroshima Kyoritsu Hospital , Hiroshima , Japan.
authors.forename: Kazuki
authors.initials: K
authors.lastname: Nishihara
keywords: ENDOSCOPIC GASTROSTOMY; ENTERAL NUTRITION; NUTRITIONAL SUPPORT