Percutaneous endoscopic jejunostomy and jejunal extension tube through percutaneous endoscopic gastrostomy: a retrospective analysis of success, complications and outcome

Digestion. 2009;79(2):92-7. doi: 10.1159/000207808. Epub 2009 Mar 12.

Abstract

Background: Percutaneous access to the jejunum is an important approach if gastrostomy feeding is not possible.

Objective: To analyze success, short- and long-term complications (STCs, LTCs) in patients with percutaneous endoscopic jejunostomy (PEJ) and jejunal access through percutaneous endoscopic gastrostomy (Jet-PEG).

Methods: A retrospective analysis of endoscopically placed PEJs and Jet-PEGs. Success rates, mortality, STCs and LTCs were investigated for risk factors comprising demographic data, underlying disease, previous surgery and experience of the endoscopist.

Results: 205 PEJ and 58 Jet-PEG placements were included in the study. PEJs and Jet-PEGs were successfully placed in 65.4 and 89.7%, respectively. Billroth II surgery predisposed in favor of a significantly higher success rate for PEJ placement (p = 0.014, OR = 2.27). Inexperienced examiners have a significantly (p = 0.040) lower success rate for tube insertion than examiners with a medium level of experience. STCs and LTCs occurred evenly in PEJ and Jet-PEG patients. Dislocation of the tube occurred significantly more frequently in Jet-PEG patients (33.3%, p = 0.005). Aspiration was most common for bedridden patients.

Conclusion: PEJ has a significantly lower success rate for insertions, but fewer LTCs. The experience of the endoscopist correlates with the success rate of tube insertion.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Endoscopy, Gastrointestinal* / adverse effects
  • Enteral Nutrition / adverse effects
  • Female
  • Gastrostomy* / adverse effects
  • Gastrostomy* / mortality
  • Germany / epidemiology
  • Humans
  • Jejunostomy* / adverse effects
  • Jejunostomy* / mortality
  • Male
  • Middle Aged
  • Retrospective Studies
  • Time Factors