Percutaneous endoscopic gastro-duodenostomy: modified technique.

Area of Science:

• Gastroenterology
• Endoscopic Procedures
• Medical Device Technology

Background:

• Patients with severe neurologic deficits often require enteral nutrition.
• Percutaneous endoscopic gastro-jejunostomy is used to prevent aspiration during tube feeding.
• Repeated aspiration events necessitate alternative feeding strategies.

Purpose of the Study:

• To describe a modified technique for endoscopic gastro-duodenostomy.
• To evaluate the safety and efficacy of this modified technique in patients with severe neurologic deficits.
• To assess the prevention of tube feeding-related aspiration.

Main Methods:

• A modified endoscopic gastro-duodenostomy technique was performed in 9 patients.
• The procedure involved trans-pyloric placement of a gastrostomy button and duodenal tube under endoscopic guidance.
• No fluoroscopy was required, and the button was repositioned as needed.

Main Results:

• Successful gastro-duodenostomy tube placement was achieved in 100% of patients without complications.
• The mean procedure time was 15 minutes.
• No tube feeding-related aspirations were observed during follow-up, though tube migration and occlusion necessitated removal in some cases.

Conclusions:

• The modified endoscopic gastro-duodenostomy is a simple, efficient, and low-cost technique.
• It is a viable option for patients with severe neurologic deficits requiring long-term enteral feeding.
• The technique effectively reduces the risk of aspiration associated with tube feeding.