PMID- 33383037
OWN - NLM
STAT- MEDLINE
DCOM- 20210707
LR  - 20210707
IS  - 1097-6779 (Electronic)
IS  - 0016-5107 (Linking)
VI  - 94
IP  - 1
DP  - 2021 Jul
TI  - Prognostic outcomes after direct percutaneous endoscopic jejunostomy in elderly 
      patients: comparison with percutaneous endoscopic gastrostomy.
PG  - 48-56
LID - S0016-5107(20)35115-4 [pii]
LID - 10.1016/j.gie.2020.12.036 [doi]
AB  - BACKGROUND AND AIMS: Direct percutaneous endoscopic jejunostomy (DPEJ) is an 
      alternative method of enteral feeding to percutaneous endoscopic gastrostomy 
      (PEG). Although long-term outcomes of PEG have been reported, little is known 
      regarding the outcomes of DPEJ. METHODS: A retrospective cohort study was 
      conducted including 115 and 651 consecutive attempts of DPEJ and PEG, 
      respectively, in a total of 766 elderly patients between April 2004 and March 
      2019. Patients' clinical background, procedural and long-term outcomes, survival 
      analysis, and cause of death were analyzed. RESULTS: Successful placement rates 
      were 93.9% and 97.1% for DPEJ and PEG, respectively. There was no significant 
      difference in procedure-related adverse events (AEs) between the DPEJ and PEG 
      groups. Rates of pneumonia, vomiting, and upper GI bleeding were significantly 
      lower, whereas those of fistula enlargement and ileus were significantly higher 
      in the DPEJ group as long-term AEs. The median survival periods were 694 and 734 
      days for DPEJ and PEG, respectively, with no significant differences between the 
      2 groups. Multivariate analysis revealed that age 80 years old or older, 
      C-reactive protein level of 1.0 mg/dL or higher, and the presence of diabetes 
      were independent risk factors for mortality after DPEJ. Respiratory tract 
      infection was the primary cause of death in both groups. CONCLUSIONS: DPEJ is 
      considered a safe and feasible method of access for enteral feeding as well as 
      PEG. Although the survival period after DPEJ may be expected to be as long as 
      that with PEG, DPEJ-specific AEs should be kept in mind on long-term feeding.
CI  - Copyright (c) 2021 American Society for Gastrointestinal Endoscopy. Published by 
      Elsevier Inc. All rights reserved.
FAU - Nishiwaki, Shinji
AU  - Nishiwaki S
AD  - Department of Internal Medicine, Nishimino Kosei Hospital, Gifu Seino Medical 
      Center, Gifu, Japan; Department of Internal Medicine, Ibi Kosei Hospital, Gifu 
      Seino Medical Center, Gifu, Japan.
FAU - Kurobe, Takuya
AU  - Kurobe T
AD  - Department of Internal Medicine, Nishimino Kosei Hospital, Gifu Seino Medical 
      Center, Gifu, Japan.
FAU - Baba, Atsushi
AU  - Baba A
AD  - Department of Internal Medicine, Nishimino Kosei Hospital, Gifu Seino Medical 
      Center, Gifu, Japan.
FAU - Nakamura, Hironori
AU  - Nakamura H
AD  - Department of Internal Medicine, Ibi Kosei Hospital, Gifu Seino Medical Center, 
      Gifu, Japan.
FAU - Iwashita, Masahide
AU  - Iwashita M
AD  - Department of Internal Medicine, Nishimino Kosei Hospital, Gifu Seino Medical 
      Center, Gifu, Japan.
FAU - Adachi, Seiji
AU  - Adachi S
AD  - Department of Gastroenterology, Gihoku Kosei Hospital, Gifu Seino Medical Center, 
      Gifu, Japan.
FAU - Hatakeyama, Hiroo
AU  - Hatakeyama H
AD  - Department of Internal Medicine, Nishimino Kosei Hospital, Gifu Seino Medical 
      Center, Gifu, Japan; Department of Internal Medicine, Ibi Kosei Hospital, Gifu 
      Seino Medical Center, Gifu, Japan.
FAU - Hayashi, Takao
AU  - Hayashi T
AD  - Department of Internal Medicine, Nishimino Kosei Hospital, Gifu Seino Medical 
      Center, Gifu, Japan.
FAU - Maeda, Teruo
AU  - Maeda T
AD  - Department of Internal Medicine, Nishimino Kosei Hospital, Gifu Seino Medical 
      Center, Gifu, Japan.
LA  - eng
PT  - Journal Article
DEP - 20201229
PL  - United States
TA  - Gastrointest Endosc
JT  - Gastrointestinal endoscopy
JID - 0010505
SB  - IM
CIN - Gastrointest Endosc. 2021 Jul;94(1):57-59. PMID: 34148579
MH  - Aged
MH  - Aged, 80 and over
MH  - Endoscopy, Gastrointestinal
MH  - *Gastrostomy/adverse effects
MH  - Humans
MH  - *Jejunostomy/adverse effects
MH  - Prognosis
MH  - Retrospective Studies
EDAT- 2021/01/01 06:00
MHDA- 2021/07/08 06:00
CRDT- 2020/12/31 20:09
PHST- 2020/09/06 00:00 [received]
PHST- 2020/12/18 00:00 [accepted]
PHST- 2021/01/01 06:00 [pubmed]
PHST- 2021/07/08 06:00 [medline]
PHST- 2020/12/31 20:09 [entrez]
AID - S0016-5107(20)35115-4 [pii]
AID - 10.1016/j.gie.2020.12.036 [doi]
PST - ppublish
SO  - Gastrointest Endosc. 2021 Jul;94(1):48-56. doi: 10.1016/j.gie.2020.12.036. Epub 
      2020 Dec 29.