Journal article
Direct endoscopic placement of percutaneous endoscopic gastrostomies with jejunal extension tubes (PEG-J) using ultra-thin endoscopes - long-term outcomes from a US tertiary referral center
Surgical endoscopy, Vol.36(6), pp.4233-4238
06/01/2022
DOI: 10.1007/s00464-021-08757-8
PMID: 34642797
Abstract
Introduction Several techniques for PEG-J tube placement have been described, commonly requiring fluoroscopic guidance and/or fixation of the jejunostomy tube (J-tube) into the small intestine. We describe a modified technique for placing jejunostomy tubes under direct visualization through a PEG with the use of ultra-thin endoscopes and steel guidewire. Methods A retrospective study at a single tertiary academic center evaluating patients who underwent PEG-J placement between 2010 and 2020. All PEG tubes were placed with a pull-through technique. The Olympus GIF-N180 endoscope was advanced through the PEG to the jejunum and a Savary-Gilliard guidewire was used for placement of the J-tube extension. Results Fifty-eight patients underwent PEG-J placement (median age 61 years; women 52%). Surgically altered gastric anatomy was observed in 11 patients (19%). Median procedure time was 44 min for new PEG-J tube placement (range 26-103) and 20 min for placement of a J-tube extension through an existing PEG tube (range 9-86) or gastrostomy tract. Technical success rate was in 100%. Sixty-two repeat procedures were performed for J-tube exchange in 27 patients (46%, range 1-9 per patient), of which 51 procedures (82%) were done using the same technique. The most common indication for tube replacement was tube dysfunction (63%, n = 39). The median procedure time for tube exchange was 20 min (range 2-62). No major adverse events were encountered. Conclusion PEG-J tubes can be placed effectively, rapidly, and safely using an ultra-thin caliber endoscope and a stiff steel wire through the PEG tube or mature gastrostomy site, precluding the need for fluoroscopy or oral access. J-tubes can be easily replaced utilizing the same technique.
Details
- Title: Subtitle
- Direct endoscopic placement of percutaneous endoscopic gastrostomies with jejunal extension tubes (PEG-J) using ultra-thin endoscopes - long-term outcomes from a US tertiary referral center
- Creators
- Yazan Hasan - University of Iowa Hospitals and ClinicsAsad Ali - University of Iowa Hospitals and ClinicsAmer El Sayed - University of IowaAvraham Levin - University of Iowa Hospitals and ClinicsHenning Gerke - University of IowaHye Yeon Jhun - University of IowaMohamad Mokadem - University of IowaRami El Abiad - University of IowaRandhir Jesudoss - University of IowaSteven Polyak - University of Iowa Hospitals and ClinicsNadav Sahar - University of Iowa Hospitals and Clinics
- Resource Type
- Journal article
- Publication Details
- Surgical endoscopy, Vol.36(6), pp.4233-4238
- Publisher
- Springer Nature
- DOI
- 10.1007/s00464-021-08757-8
- PMID
- 34642797
- ISSN
- 0930-2794
- eISSN
- 1432-2218
- Number of pages
- 6
- Language
- English
- Date published
- 06/01/2022
- Academic Unit
- Gastroenterology and Hepatology; Internal Medicine
- Record Identifier
- 9984359900502771
Metrics
9 Record Views