PMID- 16393220
OWN - NLM
STAT- MEDLINE
DCOM- 20060127
LR  - 20220311
IS  - 0002-9270 (Print)
IS  - 0002-9270 (Linking)
VI  - 100
IP  - 12
DP  - 2005 Dec
TI  - Direct percutaneous endoscopic jejunostomy: outcomes in 307 consecutive attempts.
PG  - 2681-8
AB  - BACKGROUND: Clinical utilization of direct percutaneous endoscopic jejunostomy 
      (DPEJ) is increasing. However, little data exist regarding important clinical 
      outcomes with DPEJ. OBJECTIVE: To describe the indications, success, and 
      complications of DPEJ in a large cohort of >300 consecutive attempted DPEJ cases 
      at our institution. METHODS: Institutional databases identified 316 consecutive 
      attempted DPEJ placements between January 1996 and August 2004. The medical 
      records of consenting patients were abstracted for demographics, indication, 
      success, complications, and follow-up. A scheme for classifying complication 
      severity was designed. RESULTS: Three hundred and seven attempts at DPEJ were 
      made on 286 patients. Of these, 209 succeeded (68%). The most common indications 
      for DPEJ included resectable distal esophageal cancer, other malignancies causing 
      obstruction, gastroparesis, prior esophageal or gastric resection, and high 
      aspiration risk. Overall, 81 adverse events (AEs) were associated with DPEJ 
      placement or removal in 69 (22.5%) cases. There were 14 serious AEs, 20 moderate 
      AEs, and 47 mild AEs. Serious AEs included 7 bowel perforations, 3 jejunal 
      volvuli, 3 major bleeds, and 1 aspiration. The only death was due to profound 
      jejunal mesenteric bleeding after an unsuccessful trocar pass. Moderate AEs 
      included 9 chronic enterocutaneous fistulae. Many of the 47 mild AEs were site 
      infections requiring oral antibiotics (23) or persistent site pain (14). 
      CONCLUSIONS: DPEJ was associated with a moderate or severe complication in 
      approximately 10% of cases. While DPEJ is a useful technique to gain enteral 
      access that obviates the need for surgery and is more reliable than percutaneous 
      gastrostomy with jejunal extension, patients and physicians should be aware of 
      the risks involved.
FAU - Maple, John T
AU  - Maple JT
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, 
      Rochester, MN 55905, USA.
FAU - Petersen, Bret T
AU  - Petersen BT
FAU - Baron, Todd H
AU  - Baron TH
FAU - Gostout, Christopher J
AU  - Gostout CJ
FAU - Wong Kee Song, Louis M
AU  - Wong Kee Song LM
FAU - Buttar, Navtej S
AU  - Buttar NS
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Am J Gastroenterol
JT  - The American journal of gastroenterology
JID - 0421030
SB  - IM
MH  - Adult
MH  - Age Factors
MH  - Aged
MH  - Cohort Studies
MH  - Digestive System Neoplasms/diagnosis/therapy
MH  - Endoscopy, Gastrointestinal/*adverse effects/*methods
MH  - Enteral Nutrition/*methods
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Jejunostomy/*adverse effects/*methods
MH  - Male
MH  - Middle Aged
MH  - Probability
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Sex Factors
MH  - Treatment Outcome
EDAT- 2006/01/06 09:00
MHDA- 2006/01/28 09:00
CRDT- 2006/01/06 09:00
PHST- 2006/01/06 09:00 [pubmed]
PHST- 2006/01/28 09:00 [medline]
PHST- 2006/01/06 09:00 [entrez]
AID - AJG334 [pii]
AID - 10.1111/j.1572-0241.2005.00334.x [doi]
PST - ppublish
SO  - Am J Gastroenterol. 2005 Dec;100(12):2681-8. doi: 
      10.1111/j.1572-0241.2005.00334.x.