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Percutaneous endoscopic gastrostomy/jejunostomy (PEG/PEJ) tube placement: a novel approach

1997; Elsevier BV; Volume: 45; Issue: 1 Linguagem: Inglês

10.1016/s0016-5107(97)70307-9

1097-6779

Leonard Leichus, Rig S. Patel, Frederick C. Johlin,

Infant Nutrition and Health

Percutaneous endoscopically placed gastrostomy tubes have been used for many years and are generally effective in providing enteral nutrition. However, significant complications occurring after a gastrostomy tube is placed can include aspiration and inadequate enteral nutrition, particularly in patients with gastroparesis. 1 Coben R Weinryb J Aspiration pneumonia in nursing home patients fed via gastrostomy tubes. Am J Gastroenterol. 1989; 84: 1509-1512 PubMed Google Scholar , 2 Coben RM Weintraub A DiMarino AJ Cohen S Gastroesophageal reflux during gastrostomy feedings. Gastroenterology. 1994; 106: 13-18 PubMed Google Scholar , 3 Berezin S Schwartz SM Halta MS Newman LJ Gastroesophageal reflux secondary to gastrostomy tube placement. Am J Dis Child. 1986; 140: 699-701 PubMed Google Scholar This has led many authors to devise methods of placing a jejunostomy tube via a gastrostomy tube, believing that if the tube is advanced past the ligament of Treitz the risk of aspiration would be decreased and enteral nutrition would be improved. However, placing the jejunostomy tube a significant distance past the ligament of Treitz, which is where the benefits of these tubes can be appreciated, has often required a great deal of time and persistence. Because of this, the use of percutaneously placed jejunostomy tubes (and their possible benefits, particularly their ability to prevent aspiration) has been called into question by some studies. 4 Henderson JM Strodel WE Gilinsky NH Limitations of percutaneous endoscopic jejunostomy. J Parenter Enteral Nutr. 1993; 17: 546-550 Crossref PubMed Scopus (46) Google Scholar , 5 Mac Fadyen Jr, BV Ghobrial R Catalano M Raijman I Concomitant placement of percutaneous endoscopic gastrostomy and jejunostomy. Surg Endosc. 1992; 6: 289-293 Crossref PubMed Scopus (9) Google Scholar , 6 Kadakia SC Sullivan HO Starnes E Percutaneous endoscopic gastrostomy or jejunostomy and the incidence of aspiration in 79 patients. Am J Surg. 1992; 164: 114-118 Abstract Full Text PDF PubMed Scopus (121) Google Scholar , 7 Coben R Weinryb J Pomerantz C Fenstemacher P Complications of jejunostomy tube feeding in nursing facility patients. Am J Gastroenterol. 1991; 86: 1610-1613 PubMed Google Scholar