PMID- 17996236
OWN - NLM
STAT- MEDLINE
DCOM- 20080404
LR  - 20171116
IS  - 0016-5107 (Print)
IS  - 0016-5107 (Linking)
VI  - 67
IP  - 2
DP  - 2008 Feb
TI  - Success rate of direct percutaneous endoscopic jejunostomy in patients who are 
      obese.
PG  - 265-9
AB  - BACKGROUND: Direct percutaneous endoscopic jejunostomy (DPEJ) is increasingly 
      used as a method for obtaining jejunal enteral access. The most cited reason of 
      unsuccessful placement is poor transillumination, which may be related to 
      obesity. Whether obesity affects failure and complication rates has not been 
      previously described. OBJECTIVE: To compare the success rate and adverse events 
      (AEs) associated with DPEJ placement in patients who were overweight and patients 
      who were obese compared with patients who were normal or underweight defined by 
      body mass index (BMI). DESIGN: Retrospective database review. SETTING: A 
      tertiary-referral center. PATIENTS: Eighty DPEJ placements between February 2000 
      and September 2005. MAIN OUTCOME MEASUREMENTS: DPEJ placement success in patients 
      who were overweight/obese (BMI >or= 25) versus patients who were normal or 
      underweight (BMI <25). Secondary end points included procedure time and AEs. 
      RESULTS: Eighty DPEJs were placed in 75 patients. Of these DPEJs, 65 (81%) 
      succeeded and 15 (19%) failed. Success rates were 23 of 24 for patients who were 
      underweight (96%), 25 of 31 for patients with normal BMI (81%), 8 of 11 for 
      patients who were overweight (73%), and 6 of 10 for persons who were obese (60%) 
      (odds ratio 3.43, 95% CI 1.03-11.44; P< .05 for BMI >or= 25 vs BMI<25). Overall, 
      AEs were not significantly different for patients with BMI <25 versus BMI >or=25 
      (24/55 vs 9/21, respectively; P= .64). However, 4 of the 5 severe AEs occurred in 
      patients with a BMI >or= 25 (P= .07). LIMITATIONS: Retrospective single center. 
      CONCLUSIONS: DPEJ placement in patients who were overweight or obese was 
      feasible, but procedural success was less frequent, and a trend toward more 
      frequent major AEs was seen than in persons with normal or decreased BMI. BMI was 
      an easily assessed preprocedural factor for DPEJ success and complication rates.
FAU - Mackenzie, Scott H
AU  - Mackenzie SH
AD  - Division of Gastroenterology, University of Utah, Salt Lake City, Utah 84132, 
      USA.
FAU - Haslem, Derrick
AU  - Haslem D
FAU - Hilden, Kristen
AU  - Hilden K
FAU - Thomas, Kristen L
AU  - Thomas KL
FAU - Fang, John C
AU  - Fang JC
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20071108
PL  - United States
TA  - Gastrointest Endosc
JT  - Gastrointestinal endoscopy
JID - 0010505
SB  - IM
CIN - Gastrointest Endosc. 2008 Feb;67(2):270-2. PMID: 18226689
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Comorbidity
MH  - Contraindications
MH  - Endoscopy, Gastrointestinal/adverse effects/*methods
MH  - Enteral Nutrition/*methods
MH  - Female
MH  - Gastroparesis/epidemiology/*therapy
MH  - Humans
MH  - Jejunostomy/adverse effects/*methods
MH  - Male
MH  - Middle Aged
MH  - Obesity/*epidemiology
MH  - Pancreatitis/epidemiology/therapy
MH  - Patient Selection
MH  - Retrospective Studies
MH  - Treatment Outcome
EDAT- 2007/11/13 09:00
MHDA- 2008/04/05 09:00
CRDT- 2007/11/13 09:00
PHST- 2007/02/07 00:00 [received]
PHST- 2007/06/18 00:00 [accepted]
PHST- 2007/11/13 09:00 [pubmed]
PHST- 2008/04/05 09:00 [medline]
PHST- 2007/11/13 09:00 [entrez]
AID - S0016-5107(07)02224-9 [pii]
AID - 10.1016/j.gie.2007.06.041 [doi]
PST - ppublish
SO  - Gastrointest Endosc. 2008 Feb;67(2):265-9. doi: 10.1016/j.gie.2007.06.041. Epub 
      2007 Nov 8.