Double-balloon enteroscopy as a rescue technique for failed direct percutaneous endoscopic jejunostomy when using conventional push enteroscopy (with video)

Outcomes of double-balloon enteroscopy-assisted direct percutaneous endoscopic jejunostomy tube placement

“…Procedural time is an important factor, especially in the setting of general anesthesia. Our mean procedure time for DBE-DPEJ was 33 minutes, similar to the previously reported mean procedure time of 31 minutes for DPEJ by push enteroscopy [8].…”

“…These studies included a small number of patients who did not have an attempt at conventional DPEJ tube placement, and the benefit of DBE over conventional push enteroscopy for DPEJ tube placement therefore cannot be delineated. However, in our small pilot study of 10 patients who had previously failed conventional DPEJ tube placement, a repeat attempt via DBE was successful in all of the patients [8]. On the basis of this study, DPEJ tube placement is performed using DBE at our institution.…”

“…placement in the jejunum. Indeed, in a small prospective pilot study, we showed that DBE-DPEJ tube placement was successful as a rescue procedure in 100 % of patients (n = 10) who failed conventional DPEJ tube placement [8]. In another small series of 10 patients, the success rate of DBE-DPEJ tube placement was 90 % [9].…”

Long-term outcomes of direct percutaneous endoscopic jejunostomy: a 10-year cohort

“…Balloon assisted enteroscopy DPEJ is also associated with a low complication rate, with a likely factor being improved visual support 17 . Success rates between single- and double-balloon assisted enteroscopy DPEJ are comparable, however double-balloon enteroscopy may be more efficient for deeper intubation of the small bowel 17 18 . These emerging data are promising for providing safer and more efficacious DPEJ procedures for patients requiring enteral feeding.…”

“…As with Maple et al 11 , the use of a 22 – 25 G venipuncture needle to immediately fix the loop of bowel soon after identifying the trans-illuminated loop of bowel prevents untoward movement of the bowel and improves the success rate. More recently, the use of balloon assisted enteroscopy has been reported to improve the technical success of DPEJ 16 17 18 19 . With use of a balloon-assisted overtube, and leaving the overtube in place during the procedure, the technical success rate was demonstrated to be 96 % 16 .…”