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Robotic-assisted Lateral Pancreaticojejunostomy for Chronic Pancreatitis

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Direct Percutaneous Endoscopic Jejunostomy: High Completion Rates with Selective Use of a Long Drainage Access

G W Moran¹, N C Fisher

¹Gastroenterology Department, Russells Hall Hospital, Dudley, West Midlands DY1 2HQ, UK.

Diagnostic and Therapeutic Endoscopy

|June 24, 2009

Summary

Direct percutaneous endoscopic jejunostomy (DPEJ) insertion is a safe and reliable method for artificial nutritional support. This technique achieved a high success rate of 97.5% with no complications in a tertiary care center.

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Area of Science:

Gastroenterology
Minimally Invasive Surgery

Background:

Direct percutaneous endoscopic jejunostomy (DPEJ) is valuable for artificial nutritional support.
High procedural failure rates are often reported for DPEJ.
Patient selection is crucial for DPEJ success.

Purpose of the Study:

To evaluate the efficacy and safety of a specific DPEJ technique.
To report the procedural success and complication rates of DPEJ.

Main Methods:

Retrospective review of 40 consecutive DPEJ insertions from 2002-2008.
Patients unsuitable for endoscopic gastrostomy were selected.
Technique involved selective use of drainage access needle, fluoroscopic guidance, and general anesthesia.

Main Results:

A high success rate of 97.5% (39/40 patients) was achieved.
The drainage access needle was used in 40% of cases.
Fluoroscopy and general anesthesia were used selectively in 47.5% and 12.5% of cases, respectively.
No procedural complications were reported.

Conclusions:

The described DPEJ technique demonstrates a high completion rate.
The technique is associated with a low complication rate.
DPEJ insertion is a reliable and safe procedure with appropriate expertise.