The complications of jejunostomy tubes for patients receiving Duodopa: New challenges for neuroscience nurses

Abstract

The use of Duodopa ® Levodopa-Carbidopa intestinal gel offers patients with advanced Parkinson’s disease (PD) an effective alternative therapy for the treatment of severe motor fluctuations and dyskinesia. This therapy requires the use of percutaneous endoscopic gastrostomy/jejunostomy tube (PEG/J) to deliver gel directly into the jejunum which poses new challenges for neuroscience nurses for the care and management of patients with PD. Due to the reported number of complications associated with PEG/J our facility opted to use a direct jejunostomy tube for the first of two PD patients which resulted in an adverse outcome for our 80 year old patient. This experience highlighted that the neuroscience nurses need to increase knowledge and understanding of PEG/J and jejunostomy care as more future patients will be treated with Duodopa, and that future studies regarding the safety and value of the direct jejunostomy tubes are warranted.

Endoscopic Complications Are More Frequent in Levodopa–Carbidopa Intestinal Gel Treatment via JET-PEG in Parkinson’s Disease Patients Compared to Nutritional PEG in Non-Parkinson’s Disease Patients

“…Several other studies confirmed that JET-PEG individuals experience higher rates of repeated endoscopies. Sücüllü Karada g et al [40] published a 36.4% incidence of technical complications, half of them requiring repeated gastroscopies [41,42]. Blaise et al [43] reported the need for repeated endoscopies in up to 68% of patients.…”