Endoscopic gastrojejunostomy: a technique to establish small bowel feeding without laparotomy

Gottfried, Edward B.; Plumser, Allan B.

doi:10.1016/s0016-5107(84)72454-0

Cited by 49 publications

(14 citation statements)

References 8 publications

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“…When gastric feeding is either not tolerated or is contraindicated, enteral feeding may be useful. Use of a gastrojejunal (GJ) feeding tube was first described about 4 years after PEG [3,4] and has been reported to be successful in adults and children [5][6][7][8][9][10][11][12], in whom it is increasingly used. One of the main indications for use of GJ tube feeding is to prevent aspiration, particularly in neurologically impaired children, in whom it is reported to be as effective as fundoplication for this purpose [13••, 14-16].…”

Section: Introductionmentioning

confidence: 99%

Frequency and Methods of Gastrojejunal Tube Replacement in Children

Shah

Klooster

Yanni

et al. 2010

Curr Gastroenterol Rep

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Gastrojejunal (GJ) tubes are increasingly used for enteral feeding in children in whom gastric feeding either is not tolerated or is contraindicated. The most common complications associated with GJ tube use are mechanical failure (clogging, cracking, deterioration) and dislodgement. Less common, but more significant, complications are bowel perforation, aspiration, and feeding intolerance. Some of these complications may be prevented by replacing GJ tubes at regular intervals. Methods to direct a GJ tube include 1) guidewire, 2) gastroduodenoscopy-guidewire, 3) esophagogastroduodenoscopy-forceps, and 4) fluoroscopy-guidewire. Clinical experience to determine the ideal method and optimal timing of GJ tube replacement is evolving. GJ tube replacement using a guidewire through the prior GJ tube, without endoscopy, fluoroscopy, or sedation, is the least risky method, but is also the least likely to be successful.

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Section: Introductionmentioning

confidence: 99%

Frequency and Methods of Gastrojejunal Tube Replacement in Children

Shah

Klooster

Yanni

et al. 2010

Curr Gastroenterol Rep

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“…Relative contraindications to PEG include obesity, severe gastroesophageal reflux, gastroparesis, neurologic disorders, history of repeated tube feeding-related aspiration, and neoplastic, inflammatory, or infiltrative disease of the gastric or abdominal walls [14]. Percutaneous endoscopic jejunostomy (PEJ) and jejunal extension through a PEG were developed to replace PEG when gastric feeding is contraindicated or not preferred [15].…”

Section: Discussionmentioning

confidence: 99%

Endoscopic identification of the jejunum facilitates minimally invasive jejunostomy tube insertion in selected cases

Selim

2009

Surg Endosc

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“…Cole et al have clearly demonstrated delayed gastric emptying and reflux of enteral feedings followed by aspiration with the use of a PEG [4]. Intrajejunal feeding appears to offer a reasonable approach to prevent aspiration by infusing the feeding distal to the pylorus [8,10,17,19]. Ryan and Page [19] concluded that "intrajejunal feeding negated the risk of gastroesophageal reflux and aspiration pneumonia."…”

Section: Discussionmentioning

confidence: 99%

“…In these cases, however, other complicating factors following gastrointestinal surgery were present including peritonitis, small-bowel obstruction, marked adhesions, intrinsic small-bowel disease, and extensive retroperitoneal dissection [13]. Endoscopic percutaneous jejunostomies have been used by some authors [2,10,17] with promising results. Recently, Wolfsen et al [20] showed a 17% incidence of aspiration after PEJ placement in contrast to only 5% with PEGs.…”

Section: Discussionmentioning

confidence: 99%

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Concomitant placement of percutaneous endoscopic gastrostomy and jejunostomy

et al. 1992

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Percutaneous endoscopic gastrostomies have gained wide use for long-term enteral nutrition. However, gastroesophageal reflux and aspiration pneumonia have occurred following this procedure. Initial enthusiasm concerning the ability of intrajejunal feeding to negate the risk of aspiration has been challenged by some reports. In this report, a new method is described for concomitant placement of endoscopic gastrostomy and feeding jejunostomy wherein the tip of the feeding jejunostomy is placed at least 40 cm distal to the pylorus while the gastrostomy tube is used for drainage. Twenty critically ill patients underwent the procedure utilizing general or local anesthesia. Sixty-day follow-up showed one uneventful episode of pulmonary aspiration (5%) after retrograde migration of the jejunal tube into the duodenum. All but two patients (90%) tolerated their tube feedings well. This technique can be easily performed with accurate placement of the PEJ tube distal to the pylorus and is associated with minimal risk of aspiration.

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Endoscopic gastrojejunostomy: a technique to establish small bowel feeding without laparotomy

Cited by 49 publications

References 8 publications

Frequency and Methods of Gastrojejunal Tube Replacement in Children

Frequency and Methods of Gastrojejunal Tube Replacement in Children

Endoscopic identification of the jejunum facilitates minimally invasive jejunostomy tube insertion in selected cases

Concomitant placement of percutaneous endoscopic gastrostomy and jejunostomy

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