Percutaneous endoscopic gastrostomy and jejunostomy: Indications and techniques

Fugazza, Alessandro; Capogreco, Antonio; Cappello, Annalisa; Nicoletti, Rosangela; Rio, Leonardo Da; Galtieri, Piera Alessia; Maselli, Roberta; Carrara, Sandro; Pellegatta, Gaia; Spadaccini, Marco; Colombo, Matteo; Khalaf, Kareem; Repici, Alessandro; Anderloni, Andrea

doi:10.4253/wjge.v14.i5.250

Cited by 16 publications

(23 citation statements)

References 102 publications

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“…Nutritional support is essential in patients who have a limited capacity to maintain their normal body weight through a normal diet 7 . Enteral nutrition is indicated for patients who have a functional gastrointestinal tract and whose oral nutritional intake is insufficient to meet the estimated nutritional needs 15 .…”

Section: Discussionmentioning

confidence: 99%

“…There has been a worldwide spread of this technique and an increase in indications for this medical approach. Of note, PEG allows the maintenance of normal physiological activities of the gastrointestinal tract and avoids long-term complications associated with intravenous nutritional support 7 . A gastric route through Percutaneous endoscopic gastrostomy enteral nutrition vs. Helicobacter pylori colonization a PEG tube is advantageous over a jejunal approach due to its better tolerance, ease of the procedure, and possibility of being performed in a bedside model 8 .…”

Section: Introductionmentioning

confidence: 99%

“…Although the benefits of PEG have been reported, several controversies and major concerns still exist regarding this procedure 7 . Previously placed PEG tubes can dislodge or be inadvertently removed, blocked, or damaged.…”

Section: Introductionmentioning

confidence: 99%

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Does enteral nutrition through a percutaneous endoscopic gastrostomy, attenuate Helicobacter pylori colonization?: is it worth mentioning?

Muhtaroğlu

Şengül

et al. 2023

Rev. Assoc. Med. Bras.

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OBJECTIVE:In patients who experience difficulties in oral feeding, alimentary intake can be supported by creating direct access into the stomach through a percutaneous endoscopic gastrostomy. The present study purposed to compare naïve and exchanged percutaneous endoscopic gastrostomy tubes in terms of Helicobacter pylori infection and other clinical characteristics. METHODS: A total of 96 cases who underwent naïve or exchanged percutaneous endoscopic gastrostomy procedures with various indications were incorporated into the study. The patients' demographic data, such as age and gender, etiology of percutaneous endoscopic gastrostomy, anti-HBs status, Helicobacter pylori status, the presence of atrophy and intestinal metaplasia, biochemical parameters, and lipid profiles, had been analyzed. In addition, the anti-HCV and anti-HIV statuses had also been evaluated. RESULTS: The most common indication for percutaneous endoscopic gastrostomy placement was dementia in 26 (27.08%) cases (p=0.033). The presence of Helicobacter pylori positivity was significantly lower in the exchange group compared to the naïve group (p=0.022). Total protein, albumin, and lymphocyte levels were significantly higher in the exchange group compared to the naïve group (both p=0.001), and the mean calcium, hemoglobin, and hematocrit levels were statistically significantly higher in the exchange group (p<0.001). CONCLUSION: Preliminary outcomes of the present study revealed that enteral nutrition attenuates the incidence of Helicobacter pylori infection. Considering the acute-phase reactant, the significantly lower ferritin values in the exchange group suggest that there is no active inflammatory process in the patients and that immunity is sufficient.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Does enteral nutrition through a percutaneous endoscopic gastrostomy, attenuate Helicobacter pylori colonization?: is it worth mentioning?

Muhtaroğlu

Şengül

et al. 2023

Rev. Assoc. Med. Bras.

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“…5 PEG is a viable enteral nutritional route for patients with upper gastrointestinal tract and head and neck malignancies, as palliation in inoperable cases, or prior to radiotherapy or chemotherapy. 6 Preoperative PEGs for esophageal cancer are safe and do not compromise future anastomoses. 7 PEG-J involves gastrostomy with a jejunal extension tube, through which the feeding solution can be administered, and gastric decompression functions are performed.…”

Section: Discussionmentioning

confidence: 99%

Retrograde transgastric jejunostomy for nutritional management and aspiration prevention in cases with severe malignant esophageal strictures

Yamashita,

Otsuka,

Goto

et al. 2023

DEN Open

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Locally advanced esophageal cancer often presents with dysphagia and can be complicated by aspiration pneumonia. Therefore, nutritional management is important to prevent pneumonia. Enteral nutrition via gastrostomies is common in esophageal cancer patients. Here, we describe the efficacy of nutritional management using a gastrojejunostomy tube retrogradely inserted in the esophagus through gastrostomy to simultaneously drain accumulated fluid on the proximal side of a malignant stricture. We performed this procedure for two cases with severe malignant strictures using two types of endoscope insertion. A 57‐year‐old male patient (Case 1) underwent a retrograde insertion of a gastrojejunostomy tube for severe esophageal malignant stricture with severe nausea and salivary reflux. After a narrow endoscope was inserted through the gastrostomy fistula, a gastrojejunostomy tube was inserted alongside a guidewire allowing the patient to undergo definitive chemoradiotherapy without symptoms. An 82‐year‐old male patient (Case 2) was scheduled for a minimally invasive esophagectomy following neoadjuvant chemotherapy after gastrostomy. However, the patient developed aspiration pneumonia due to salivary reflux; before surgery, a narrow nasal endoscope was inserted and passed through the strictures. The percutaneous endoscopic transgastric jejunostomy catheter was retrogradely inserted alongside the guidewire. In patients with malignant strictures and salivary reflux, retrograde insertion of gastrojejunostomy tubes can simultaneously provide enteral nutrition and saliva drainage.

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“…13 Its whole procedure is easy, associated with low morbidity and mortality. 14 Many previous studies have compared the advantages and disadvantages of the two techniques. Baeten et al recruited 90 patients in their study, of whom 44 were randomized to the NGT group and 44 to the PEG group.…”

Section: Discussionmentioning

confidence: 99%

Comparison Between Percutaneous Endoscopic Gastrostomy and Nasogastric Feeding in 160 Patients with Swallowing Disturbances: A Two-Year Follow-Up Study

Du¹,

Liu²,

Chen³

et al. 2022

CIA

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We retrospectively compared the complications, blood biochemical indexes and outcomes in patients with swallowing disturbances receiving nasogastric tube (NGT) feeding and percutaneous endoscopy gastrostomy (PEG). Methods: Among 160 patients, 72 cases received PEG and 88 cases received NGT. All patients were followed up for two years. We collected their clinical data from the medical records. Indicators, such as body mass index (BMI), white blood cell (WBC), hemoglobin (HGB), complications, including recurrent aspiration pneumonia, gastrointestinal bleeding, reflux esophagitis, and outcomes (survival or death) were compared between the two groups semi-annually. Results: SAt both six months and one year after receiving treatment, there was no statistical difference between the two groups in indicators, complications and outcomes, with all P >0.05. It can be seen that, when the patients were followed up for one and a half years18 months, ALB was lower in the NGT group (33.81±0.46) compared with the PEG group (36.14±0.50) (P <0.05). After two years of follow-up, differences between the NGT and PEG group could be seen in a variety of indicators, including BMI (20.08±0.27 vs 21.03±0.25), WBC (9.12±0.56 vs 7.08±0.29), ALB (33.11±0.43 vs 35.75±0.49), creatinine (55.07±1.83 vs 63.21±2.94), and the complications, such as aspiration pneumonia, gastrointestinal bleeding, reflux esophagitis, and electrolyte disorder, in the PEG group were significantly reduced compared to the NGT groupthan that in its counterpart, P <0.05. In the two-year follow-up period, there were 13 and 22 patients died in the PEG group and NGT group, respectively. Conclusion: Both techniques are safe and effective in the short term. However, on a longer-term basis, PEG is shown to be superior to NGT feeding in improving nutrition and preventing common complications for patients with swallowing disturbances.

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Percutaneous endoscopic gastrostomy and jejunostomy: Indications and techniques

Cited by 16 publications

References 102 publications

Does enteral nutrition through a percutaneous endoscopic gastrostomy, attenuate Helicobacter pylori colonization?: is it worth mentioning?

Does enteral nutrition through a percutaneous endoscopic gastrostomy, attenuate Helicobacter pylori colonization?: is it worth mentioning?

Retrograde transgastric jejunostomy for nutritional management and aspiration prevention in cases with severe malignant esophageal strictures

Comparison Between Percutaneous Endoscopic Gastrostomy and Nasogastric Feeding in 160 Patients with Swallowing Disturbances: A Two-Year Follow-Up Study

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