title: Short- and long-term outcomes from percutaneous endoscopic gastrostomy with jejunal extension.
abstract: There is a paucity of data regarding the safety and efficacy of percutaneous endoscopic gastrostomy with jejunal extension (PEG-J). We evaluated adverse events related to PEG-J and determined the clinical impact of PEG-J in those with chronic pancreatitis (CP).
  
  
  
  This cohort study included all patients who underwent PEG-J placement in a tertiary-care academic medical center between 2010 and 2012. Main outcome measurements were (1) short- and long-term complications related to PEG-J and (2) changes in weight and hospitalizations during the 12-month period before and after PEG-J in the CP subgroup.
  
  
  
  Of 102 patients undergoing PEG-J placement, the overall technical success rate was 97 %. During a median follow-up period of 22 months (1-46 months, n = 90), at least one tube malfunction occurred in 52/90 (58 %; 177 episodes) after a median of 53 days (3-350 days), requiring a median of two tube replacements. Short-term (<30 days) tube malfunction occurred in 28/90 (31 %) and delayed in 24/90 (27 %); these included dislodgement (29 %), clogging (26 %) and kinking (14 %). In the CP subgroup (n = 58), mean body weight (kg) (70 vs. 71, p = 0.06) and body mass index (kg/m2, 26 vs. 27, p = 0.05) increased post-PEG-J. Mean number of hospitalizations (5 vs. 2, p < 0.0001) and inpatient days per 12 months (22 vs. 12, p = 0.005) decreased.
  
  
  
  While we observed no major complications related to PEG-J, half of patients had at least one episode of tube malfunction. In the CP subgroup, jejunal feeding via PEG-J significantly reduced the number of hospitalizations and inpatients days, while improving nutritional parameters.
authors: Indiana University School of Medicine, Indianapolis, IN, USA.|King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Chulalongkorn University, Bangkok, Thailand.
authors: Wiriyaporn
authors: W
authors: Ridtitid
authors: Indiana University School of Medicine, Indianapolis, IN, USA.
authors: Glen A
authors: GA
authors: Lehman
authors: Indiana University School of Medicine, Indianapolis, IN, USA.
authors: James L
authors: JL
authors: Watkins
authors: Indiana University School of Medicine, Indianapolis, IN, USA.
authors: Lee
authors: L
authors: McHenry
authors: Indiana University School of Medicine, Indianapolis, IN, USA.
authors: Evan L
authors: EL
authors: Fogel
authors: Indiana University School of Medicine, Indianapolis, IN, USA.
authors: Stuart
authors: S
authors: Sherman
authors: Indiana University School of Medicine, Indianapolis, IN, USA. cotea@musc.edu.|Medical University of South Carolina, 114 Doughty Street, MSC 702, Room 249, Charleston, SC, 29425, USA. cotea@musc.edu.
authors: Gregory A
authors: GA
authors: Coté
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects / Q000379:methods*; D004750:Enteral Nutrition / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005774:Gastrostomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D050500:Pancreatitis, Chronic / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies
keywords: Chronic pancreatitis; Enteral feeding; Enteral nutrition; Percutaneous endoscopic gastrostomy with jejunal extension