Perkutane Enterostomie – Schritt für Schritt

Duckworth-Mothes, Benedikt; Zipfel, A.; Grund, K. E.

doi:10.1055/a-1372-4697

Cited by 4 publications

(16 citation statements)

References 9 publications

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“…Serious complications are mainly triggered by the fact that the decisive adequate contact pressure until the peritoneal sheets are firmly connected (decisive safety factor in every PEG) is not controlled or not permanently guaranteed (Duckworth-Mothes et al 2022).…”

Section: Peg In Thread Pull-through Technique (Tpt)mentioning

confidence: 99%

“…Simple measures can be taken to optimise the apposition area on the one hand and to eliminate the risk of malpuncture on the other (Grund et al 2006a;Grund and Zipfel 2016;Duckworth-Mothes et al 2022).…”

Section: Direct Puncturementioning

confidence: 99%

“…The technique of thread pull-through PEG (FDZ-PEG) just described can be decisively improved by combining it with gastropexy (endoscopic suturing of the anterior gastric wall to the abdominal wall) (Hybrid-PEG) (Grund et al 2021;Kishta et al 2021;Duckworth-Mothes et al 2022).…”

Section: Hybrid Pegmentioning

confidence: 99%

“…6, Table 4). The important ones are (Grund et al 2006a;Grund et al 2021;Duckworth-Mothes et al 2022):…”

Section: Hybrid Pegmentioning

confidence: 99%

“…The technique is quite critical and requires a decided and standardised procedure as an absolute prerequisite for similar success rates as with "normal" PEG. Defined prerequisites are (Grund et al 2006a;Duckworth-Mothes et al 2022):…”

Section: Epj = D-pejmentioning

confidence: 99%

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Optimised endoscopic access for intrajejunal levodopa application in idiopathic Parkinson's syndrome

et al. 2023

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Pump-guided intrajejunal levodopa administration is one of the indispensable forms of therapy in advanced Parkinson's syndrome, along with deep brain stimulation and subcutaneous apomorphine injection. The standard application of levodopa gel via a JET-PEG, i.e. a percutaneous endoscopic gastrostomy (PEG) with an inserted internal catheter into the jejunum, has not been unproblematic due to the restricted absorption area of the drug in the region of the flexura duodenojejunalis and especially due to the sometimes considerable accumulated complication rates of a JET-PEG. Causes of complications are mainly a non-optimal application technique of PEG and internal catheter as well as the often missing adequate follow-up care. This article presents the details of a—compared to the conventional technique—modified and optimised application technique, which has been clinically proven successfully for years. However, many details derived from anatomical, physiological, surgical and endoscopic aspects must be strictly observed during the application to reduce or avoid minor and major complications. Local infections and buried bumper syndrome cause particular problems. The relatively frequent dislocations of the internal catheter (which can ultimately be avoided by clip-fixing the catheter tip) also prove to be particularly troublesome. Finally, using the Hybrid technique, a new combination of an endoscopically controlled gastropexy with 3 sutures and subsequent central thread pull-through (TPT) of the PEG tube, the complication rate can be dramatically reduced and thus a decisive improvement achieved for patients. The aspects discussed here are highly relevant for all those involved in the therapy of advanced Parkinson's syndrome.

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Section: Peg In Thread Pull-through Technique (Tpt)mentioning

confidence: 99%

Section: Direct Puncturementioning

confidence: 99%