PMID- 35433212
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220716
IS  - 2364-3722 (Print)
IS  - 2196-9736 (Electronic)
IS  - 2196-9736 (Linking)
VI  - 10
IP  - 4
DP  - 2022 Apr
TI  - Direct percutaneous endoscopic jejunostomy (DPEJ) and percutaneous endoscopic 
      gastrostomy with jejunal extension (PEG-J) technical success and outcomes: 
      Systematic review and meta-analysis.
PG  - E488-E520
LID - 10.1055/a-1774-4736 [doi]
AB  - Background and study aims  Endoscopic methods of delivering uninterrupted feeding 
      to the jejunum include direct percutaneous endoscopic jejunostomy (DPEJ) or PEG 
      with jejunal extension (PEG-J), validated from small individual studies. We aim 
      to perform a meta-analysis to assess their effectiveness and safety in a variety 
      of clinical scenarios. Methods  Major databases were searched until June 
      2021. Efficacy outcomes included technical and clinical success, while safety 
      outcomes included adverse events (AEs) and malfunction rates. We assessed 
      heterogeneity using I (2) and classic fail-safe to assess bias. Results  29 
      studies included 1874 patients (983 males and 809 females); mean age of 60 +/- 19 
      years. Pooled technical and clinical success rates with DPEJ were 86.6 % (CI, 
      82.1-90.1, I (2) 73.1) and 96.9 % (CI, 95.0-98.0, I (2) 12.7). The pooled 
      incidence of malfunction, major and minor AEs with DPEJ were 11 %, 5 %, and 15 %. 
      Pooled technical and clinical success for PEG-J were 94.4 % (CI, 85.5-97.9, I (2) 
      33) and 98.7 % (CI, 95.5-99.6, I (2)  < 0.001). The pooled incidence of 
      malfunction, major and minor AEs with DPEJ were 24 %, 1 %, and 25 %. 
      Device-assisted DPEJ performed better in altered gastrointestinal anatomy. First 
      and second attempts were 87.6 % and 90.2 %. Conclusions  DPEJ and PEG-J are safe 
      and effective procedures placed with high fidelity with comparable outcomes. DPEJ 
      was associated with fewer tube malfunction and failure rates; however, it is 
      technically more complex and not standardized, while PEG-J had higher placement 
      rates. The use of balloon enteroscopy was found to enhance DPEJ performance.
CI  - The Author(s). This is an open access article published by Thieme under the terms 
      of the Creative Commons Attribution-NonDerivative-NonCommercial License, 
      permitting copying and reproduction so long as the original work is given 
      appropriate credit. Contents may not be used for commercial purposes, or adapted, 
      remixed, transformed or built upon. 
      (https://creativecommons.org/licenses/by-nc-nd/4.0/).
FAU - Deliwala, Smit S
AU  - Deliwala SS
AD  - Department of Internal Medicine, Michigan State University at Hurley Medical 
      Center, Flint, Michigan, United States.
FAU - Chandan, Saurabh
AU  - Chandan S
AD  - Gastroenterology and Hepatology, CHI Health Creighton University Medical Center, 
      Omaha, Nebraska, United States.
FAU - Kumar, Anand
AU  - Kumar A
AD  - Gastroenterology & Hepatology, Lenox Hill Hospital, New York, New York, United 
      States.
FAU - Mohan, Babu
AU  - Mohan B
AD  - Gastroenterology & Hepatology, University of Utah, Salt Lake City, Utah, United 
      States.
FAU - Ponnapalli, Anoosha
AU  - Ponnapalli A
AD  - Department of Internal Medicine, Michigan State University at Hurley Medical 
      Center, Flint, Michigan, United States.
FAU - Hussain, Murtaza S
AU  - Hussain MS
AD  - Department of Internal Medicine, Michigan State University at Hurley Medical 
      Center, Flint, Michigan, United States.
FAU - Kaushal, Sunil
AU  - Kaushal S
AD  - Gastroenterology, Mclaren Health Corporation, Flint, Michigan, United States.
FAU - Novak, Joshua
AU  - Novak J
AD  - Division of Digestive Diseases, Department of Medicine, Emory University School 
      of Medicine, Atlanta, Georgia, United States.
FAU - Chawla, Saurabh
AU  - Chawla S
AD  - Division of Digestive Diseases, Department of Medicine, Emory University School 
      of Medicine, Atlanta, Georgia, United States.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20220414
PL  - Germany
TA  - Endosc Int Open
JT  - Endoscopy international open
JID - 101639919
PMC - PMC9010104
COIS- Competing interests The authors declare that they have no conflict of interest.
EDAT- 2022/04/19 06:00
MHDA- 2022/04/19 06:01
PMCR- 2022/04/01
CRDT- 2022/04/18 06:37
PHST- 2021/08/05 00:00 [received]
PHST- 2021/10/19 00:00 [accepted]
PHST- 2022/04/18 06:37 [entrez]
PHST- 2022/04/19 06:00 [pubmed]
PHST- 2022/04/19 06:01 [medline]
PHST- 2022/04/01 00:00 [pmc-release]
AID - 10.1055/a-1774-4736 [doi]
PST - epublish
SO  - Endosc Int Open. 2022 Apr 14;10(4):E488-E520. doi: 10.1055/a-1774-4736. 
      eCollection 2022 Apr.